Organ transplantation is the first effective treatment for end-stage organ failure. However, early acute rejection after organ transplantation is often an important factor leading to transplantation failure. In order to reduce the incidence of rejection after organ transplantation, it is often necessary to use potent immunosuppressants to induce the immune system of recipients before or during transplantation. As a common method of covering immunosuppressive therapy in the early stage of organ transplantation, antibody immunoinducers can significantly reduce the occurrence of early acute rejection after organ transplantation, and delay or reduce the application of calcineurin inhibitor drugs, which is conducive to protecting renal function, promoting graft function recovery and long-term survival of recipients. This article reviews the application of antibody inducers in solid organ transplantation.

Objective To investigate the protective effect of propotol against hepatic ischemiareperfusion injury in rats on mitochondrial permeability transition pore (MPTP) and the mechanism of GSK-3β.Methods Thirty SD rats were randomly assigned into five groups (n =6):sham operation group (S group),ischemia reperfusion group (I/R group),CsA pretreatment group (C group),propofol pretreatment group (P group),and propofol plus atractyloside pretreatment group (A + P group).Nauta liver ischemia-reperfusion rat model was used.Liver lobes were subjected to warm ischemia for 60min and then reperfusion for 120 min.In P group,propofol [12 mg/(kg · h)] was administered in the femoral vein for 30 min before ischemia until the end of reperfusion.In C group,CsA (2 mg/kg) was administered in the femoral vein for 20min before ischemia.In A + P group,20 μmol/kg of atractyloside was given through the femoral vein 10min before the injection of propofol.Rats were sacrificed at the end of reperfusion,and venous blood and hepatic tissue specimens from the same part of ischemia were obtained from different groups.Results Compared with S group,the AST and ALT levels were increased significantly,mitochondrial swelling were increased and mitochondrial membrane potential were decreased significantly in I/R group and A + P group.Casepase-3 were increased significantly and p-GSK3β Ser9 were decreased significantly in I/R group and A + P group.Compared with I/R group,the content of AST and ALT were decreased significantly,mitochondrial swelling were decreased and mitochondrial membrane potential were increased significantly,casepase-3 release were decreased significantly and p-GSK3β Ser9 were increased significantly in P group and C group.GSK-3β in each group displayed no significant difference.Conclusions Propofol can significantly reduce hepatic ischemia-reperfusion injury.The protective effect of propofol may be achieved via the inhibition of GSK-3β activation,increased p-GSK-3β Ser9 level,suppressing MPTP opening and decreasing hepatocytes apoptosis.

Objective To investigate the correlation between the unilateral middle cerebral artery (MCA)stenosis ratio and cerebrovascular reserve(CVR) using computed tomography perfusion (CTP) and CO2 inhalation test in patients with unilateral middle cerebral artery stenosis.Methods CTP were performed in 31 patients who were diagnosed as unilateral middle cerebral stenosis before and after CO2 inhalation.The basal ganglia and radial dimension were selected as interested regions (thickness 8 mm).The value of cerebral blood flow (CBF) was measured and the mean CBF values of all interested regions in each MCA territory were harvested separately.Then the CVR of each MCA territory was calculated according to the following formula:CVR =(CBF after CO2 inhalation test-CBF before CO2 inhalation test)/ CBF before CO2 inhalation test × 100％.Patients were divided into two groups:the severe stenosis group and the moderate stenosis group.The association between the MCA stenosis ratio and the CVR values was investigated.Results In 31 patients,different changes of CBF were found in affected MCA territory after CO2 inhalation.CBF increased in 17 cases,unchanged in 2 cases and decreased in 12 cases.A decreased CVR was detected in 51.6％ of the patients(16/31) and more likely found in the severe stenosis group (13/19) than that in the moderate stenosis group(3/12,P =0.029).The degree of stenosis in MCA was also significantly correlated with the changes of CVR(r =0.423,P =0.018).Conclusions CVR is decreased in some patients with unilateral MCA stenosis and significantly correlates with the severity of stenosis in MCA.

Humans ; Male ; Myocardial Infarction ; complications ; Nephrotic Syndrome ; complications ; Young Adult

Objective To evaluate the application value of combination of low kV,low mAs,and iterative model reconstruction (IMR) in carotid CT angiography.Methods Forty patients (BMI 20-25 kg/m2) were enrolled and randomly divided into routine dose group(20) and low dose group(20),The parameters in routine dose group were 120 kV,automatic mAs,and filter back projection(FBP);and that in low dose group were 80 kV,automatic mAs but upper limit 150 mAs,and FBP or IMR.All patients received the injection of 32 ml of iopamidol(370 mg I/100 ml) at a flow rate of 4 ml/s,followed by 50 ml normal saline at the same rate.The CT value and image noise(SD)of the aortic arch,left carotid artery bifurcation,and right carotid artery of rock bone were measured with region of interest(ROI) method,and then signal to noise ratios (SNR) and contrast to noise ratio (CNR)of image were calculated.The image quality was evaluated by two radiologists using a subjective four points scale on multiplanar reformated (MPR),maximum density projected (MIP) and volume rendered (VR) images.Volume CT dose index (CTDIvol),dose length product (DLP),and the effective dose (E) of each patient were recorded.Results CT values of carotid artery[(479.87 ± 70.28),(514.78 ± 82.69),(436.50 ± 89.87) HU] in low dose group were significantly higher than those in routine dose group [(295.63 ± 34.75),(325.09 ± 37.81),(286.93±36.46)HU](t =-6.47,-5.76,-3.66,P＜0.05).The SNR and CNR of IMR reconstructed image in low dose group were significantly higher than those of FBP reconstructed image in routine dose group (t =-7.54,-3.55,-5.31,-7.13,-5.28,-8.35,P＜0.05).The image quality of FBP reconstructed images in routine dose group and IMR reconstructed images in low dose group were all enough for diagnosis.The image quality of FBP reconstructed images in low dose group was significantly poorer than that in routine dose group and IMR reconstructed images in low dose group (Z =-2.87,-3.69,P ＜0.05).The effective dose in low dose group (0.57 ±0.13) mSv was 73％ less than that in routine dose group (2.22 ± 0.36) mSv.Conclusions Using low kV,low mAs,and IMR would help to obtain good carotid CT angiographic images and low radiation dose.

The aim of this study is to determine the diversity of virulence genes carried by different vancomycin-resistant enterococci (VRE),which will provides a basis for studying pathogenic mechanism of VRE.Microdilution-based drug sensitivity test was applied to detect the vancomycin resistance of 490 Enterococcus faecium isolates and 862 Enterococcus faecalis isolates in Zhejiang area.The seven virulence genes (ace,asa1,cylA,efaA,esp,gelE and hyl) in the isolates of VRE were detected by PCR.According to the results of drug sensitivity test,10％ of the E.faecium isolates (49/490) and 0.8％ of the E.faecalis (7/862) were identified as VRE.In the vancomycin-resistant E.faecium isolates,five isolates were negative for any of the target genes and the other 44 isolates were positive for asa1,esp,gelE and hyl genes alone,in which the esp (73.5％,36/49) and hyl (53.1％,26/49) were the predominant genes and single or double virulence genes acted as the major carrying models.Except for the hyl gene,the vancomycin-resistant E.faecalis isolates were positive for the other six pathogenic genes,and the isolates could carry 3-6 pathogenic genes.All the data indicate that E.faeciurn is the major species of VRE in the local area,and the carrying rate,types and models of virulence genes in the vancomycin-resistant E.faecium and E.faecalis isolates are obviously different.

Objective To know the prevalence of chronic obstructive pulmonary disease(COPD) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) in Kunming Yunnan Province, and the clinical symptom of OS.Methods Retrospective study of 4 636 cases of patients with snoring, excluding COPD in addition to chronic respiratory disease and assess the patient`s condition.The test included AHI, BMI, Epworth sleepiness scale, lung function.The index of OS was confirmed by AHI>5 times/h and FEV1/FVC<70%.Results During the period of 2006 to 2012, he prevalence of COPD in patients with OSAHS was 10.1% [95% confidence interval (CI) 9.1%-11.1%] in Kunming Yunnan Province.And male`s OS prevalence rate is higher than the female(male 10.2%;female 9.7%).The OS patients` average age was 56.9±14.1, the mean AHI was (47.46±26.79) times/h, and the average FEV1/FVC was 60.09%±23.57%.Polysomnographyresults show that patients suffered obvious hypoxiaat night in both OSAHS group and OS group, but it was more significant in OS group.Pulmonary function test showed that OS patients have more serious chronic obstructive pulmonary disease.Conclusions The prevalence of COPD in OSAHS patients was high in Kunming, Yunnan Province, and the prevalence rate in old group reached more than 24%.In addition, the sympotms of patients with OS were more severe than those with only OSAHS or COPD in lung function and hyoxemia.

Objective To investigate the infection characteristics and drug resistance of methicillin resistant Staphylococcus aureus after liver transplantation.Methods Retrospectively analyzed the clinical data of 170 patients who underwent liver transplantation in Beijing Chaoyang Hospital,Capital Medical University between January 2011 and April 2016.The incidence,pathogenic characteristics,distribution and drug resistance of methicillin resistant Staphylococcus aureus were analyzed.Results In this research,the methicillin resistant Staphylococcus aureus infection occurred in 23 cases after liver transplantation,and the incidence rate was 13.53％ (23/170).There were 27 strains of pathogens had been isolated,and 74.07％ (20/27) of pathogens were isolated from peritoneal drainage fluid.The most common methicillin resistant Staphylococcus aureus were Staphylococcus haemolyticus,Staphylococcus epidermidis and Staphylococcus hominis,accounting for 29.63％ (8/27),22.22％ (6/27) and 14.81％ (4/27).Drug sensitivity results indicated that the methicillin resistant Staphylococcus aureus were completely resistant to Penicillin,Oxacillin and Methicillin antibiotics.And the pathogens were extensively drug-resistant to Ciprofloxacin,Levofloxacin and Moxifloxacin,the resistance rates were 63％ (15/24),63％ (15/24) and 58％ (14/24).But the pathogens were sensitive to Teicoplanin,Vancomycin and Linezolid,and there have not been detected drug-resistant bacteria.Conclusions The infection of methicillin resistant Staphylococcus aureus is one of the most common pathogens after liver transplantation.Routine prophylactic antibiotics are not useful for the treatment,however,Teicoplanin,Vancomycin and Linezolid can be used as the first choice of treatment.

Objective:To investigate the influence of P27RF-Rho mRNA gene silencing in the drug sensitivity of 5-fluorouracil(5-Fu)to the liver cancer SMMC cell line,and to provide theoretical basis for the treatment of advanced liver cancer.Methods:The P27RF-Rho RNAi vector was constructed and the P27RF-Rho gene silencing lentivirus were used to infect the SMMC7721 cells.Western blotting method was used to detect the gene silencing effect.The SMMC7721 cells were divided into Scramble-siRNA group, 5-Fu group, P27RF-Rho siRNA group and P27RF-Rho siRNA + 5-Fu group.Western blotting was used to detect the transfection efficiency of RNAi.MTT method was used to detect the cell growth in various groups.Scratching test was used to detect the migration ability of cells in various groups.Transwell experiment were used to detect the invasion ability of cells in various groups.The expressions of P27 and RhoC protein were detected by Western blotting method.Results:P27RF-Rho RNAi lentiviral vector was successfully constructed.The Western blotting results showed that the expression of P27RF-Rho protein in P27RF-Rho siRNA group was decreased compared with 5-Fu group and Scramble-siRNA group(P<0.05).Compared with other three groups, the growth speed of the cells in P27RF-Rho siRNA + 5-Fu group was significantly decreased(P<0.05).The migration ability of the cells in P27RF-Rho siRNA + 5-Fu group was significantly lower than those in other three groups (P<0.01);the average number of cells passing through the Transwell microporous membrane was significantly less than those in other three groups (P<0.01).The Western blotting analysis results showed that the expression level of P27 protein in the cells in P27RF-Rho siRNA + 5-Fu group was significantly higher than those in other three groups(P<0.05);the expression level of RhoC protein was significantly lower than those in other three groups(P<0.05).Conclusion:P27RF-Rho gene silencing can significantly enhance the drug sensitivity of 5-Fu to SMMC7721 cells.

Objective To explore the diagnostic value and optimal cut-off point of symptom index (SI) in gastroesophageal reflux-induced chronic cough (GERC).Methods The recordings of multichannel intraluminal esophageal impedance and pH monitoring were retrospectively analyzed in 118 patients with suspicious GERC.SI for all the refluxes,acid reflux and non-acid reflux was calculated respectively by analyzing the temporal association between detected reflux and cough recorded on diary card.Based on the favorable response to the anti-reflux therapy,the diagnostic value for GERC of SI was evaluated and compared with that of the symptom association probability (SAP).Results GERC was definitely determined in 100 patients (84.7％).When SI for all the refluxes was used for the diagnosis of GERC,the cut-off point of ≥45％ had the highest diagnostic efficacy,with the sensitivity of 56.0％,the specificity of 83.3％and Youden index of 0.393.SI for acid or non-acid reflux had the same optimal cut-off point of ≥30％ and presented with the similar efficacy in the diagnosis of acid or non-acid GERC.Compared with SAP of ≥75％,SIforall the refluxes of ≥45％ had a lower sensitivity (56.0％ vs 75.0％,x2 =7.988,P=0.005),a higher specificity (83.3％ vs 44.4％,x2 =5.900,P =0.015) and the comparable positive or negative predictive value in the diagnosis of GERC.The diagnostic accuracy for GERC was further improved when combining SI for all the refluxes with SAP.Conclusion SI for all the refluxes has a diagnostic value similar to SAP and its optimal cut-off point for GERC may be ≥45％.