BACKGROUND: Previous experiments have shown that transforming growth factor-?1 (TGF-?1),matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) play an important role in chronic allograft nephropathy,but the mechanisms remains unclear. OBJECTIVE: To investigate the expression and significance of TGF-?1,MMP-2 and TIMP-1 in the renal tissues of chronic allograft nephropathy and normal renal tissues. DESIGN,TIME AND SETTING: A histological and morphological control observational experiment of cytology was performed at Pathological Laboratory of the 175th hospital from June to October 2008. PARTICIPANTS: The transplanted renal tissues extracted from 24 patients with chronic allograft nephropathy were used in the experiment,and the normal renal tissues in 10 patients were assigned as controls. METHODS: Immunohistochemical staining was performed in all the renal tissues. All the renal tissues were fixed with formaldehyde and embedded by paraffin wax. Then the sections were prepared with a thickness of 3 ?m,and were then closed with normal non-immune serum. Subsequently,the sections were incubated as follows: primary antibody,secondary antibody,streptavidin peroxidase complex,and diaminobenzidine (DAB),followed by HE counterstaining. The sections were cleared and coverslipped. MAIN OUTCOME MEASURES: The expressions of TGF-?1,MMP-2 and TIMP-1 in the renal tissues were observed by immunohistochemical staining. The relationships among TGF-?1,MMP-2 and TIMP-1,as well as between them and the grade of chronic allograft nephropathy were analyzed. RESULTS: Qualitative analysis: The TGF-?1,MMP-2 and TIMP-1 showed strongly positive expressions in the cytoplasm and membrane of renal tubular epithelial cells in transplanted renal tissues. Quantitative analysis: There were significant differences in expression of TGF-?1,MMP-2 and TIMP-1 between in transplanted renal tissues and in normal renal tissues (P

Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation (all-HSCT),and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients.Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation,14 d,28 d,3 m,6 m,9 m,1 y,1.5 y,2 y,2.5 y,and above 2.5 y after HSCT,and analyse thymic output function and related factors after HSCT.sjTREC levels in 24 normal individuals were also determined to use as the normal range.Results The mean of Log (sjTREC copies/ml) in normal individuals was 3.74±0.26.Negative correlation existed between thte Log sjTREC and the age (r =-0.65,P ＜ 0.01).There was no clear association between the TREC and the gender.Log sjTREC in pre-transplantation patients was 3.09±0.52,and the levels of sjTREC in 14 d,28 d,6 m,1 y after HSCT were 1.18±0.22,2.16±0.31,1.31±0.2,1.83±0.31,respectively.There was no significant difference between normal individuals and patients 1.5 years after HSCT.The post-transplantation level of sjTREC was not related to the age,but was negatively correlated to the acute graft versus host disease (aGVHD) 1 year after HSCT.There was no difference between patients with or without aGVHD 1.5 years post-HSCT.Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT.The recovery of thymic output function after allo-HSCT is slow,in which aGVHD may have a negative effect.

Men aged 40-59 years (325 subjects) from 4 districts, 6 populations, 3 nationalities were investigated to explore the relationship between element and blood pressure (BP) . Fe, Mo, Ni, Pb, Si, Sn, Sr, V, Cd, Co, Cr, Cu, Mn, Zn, Ca, and Mg -were measured by ion coupled plasma spectroscopy, Se by catalytic pulse polarography. Results showed; (1) The element levels were different among districts and nationalities. (2) The correlation coefficients among serum Pb, Ni, Si, Sn, V, Cd, Cr were rather high, while Sr behaved relatively independently. (3)Using multivariant stepwise regression and discrimination analysis, serum Sr was found to associate positively with BP in normotensive and hypertensive and total pooled groups without exce-piton. (4) Serum Ca (Ca/Mg), Fe, Co were positively associated, while Cr, Sn inversely associated with BP. (5) The harmful element Cd was unexpectedly found to be inversely associated with BP and it was lower in those populations with high BP levels, which might be ascribed to the non-parallel distribution of certain elements in body tissues and blood. Results also indicated; (1) The levels of essential element Ni, V, Co, Cr were lower in hypertensive group. (2) Serum Ca and urinary Ca were non-parallel, and the former could not accurately reflect Ca-intake. In short, the relationship between element and BP still remains to be elucidated.

Objective To evaluate the safety and efficacy of overlapping sirolimus-eluting stent (SES) for long lesions during primary percutanous coronary intervention(PCl) in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods Seven hundred and seventy-five elderly patients with STEMI who underwent primary PCI were enrolled and followed up. Patients with two or more SES implanted for long lesions during PCI were taken as long lesion group and patients with single stents implanted were regarded as control group. The safety endpoints were in-hospital and follow-up death and stem thrombosis, and the clinical endpoints were the incidence of restenosis and target vessel revascularization rate during in-hospital follow-up and 6 months" follow-up.Results Among 775 patients, 62 patients had 64 long lesions. The average number of stents was 2. 2, and the average lesion length and stent length implanted were (45.3±10. 4)mm and (52.2±11.0)mm, respectively. During the 6 months' follow-up, the incidence of angiographically documented stent thrombosis were 1.6% in long lesion group and 1.1% in control group, respectively. No death or myocardial infarction occurred in two groups. There was no significant difference in the incidence of restenosis and target vessel revascularization rate between long-lesion group and control group (8. 1 vs. 4.8%, 6.9% vs. 3. 7%, both P>0.05). Conclusions Overlapping implantation of homemade SES is safe and effective for STEMI patients with long lesions in short-term period.

Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P<0. 01). No difference was found in in-hospital mortality among three groups (2. 9% vs. 2.3% vs. 2. 2%, P> 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.

Objective: To evaluate the safety and efficacy of overlapping Sirolimus-eluting stents (SES) in very long lesions during primary percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI).Methods: A total of 297 consecutive patients with STEMI underwent primary PCI from January to December 2007 in our hospital were studied.We identified the patients who had 2 or more SES implanted in single long lesion with a single procedure.6 months angiographic and clinical follow-up was performed.The incidences of restenosis and major adverse cardiac event (MACE) during hospitalization and at the follow-up time were analyzed.Results: We identified 31 patients with 31 long lesions who had been implanted more than 2 stents.A median of 2.1 stents were implanted, the median lesion length was 47.2±10.3mm and a median implanted stents'length was 53.2±10.5 mm.6 months clinical follow up rate was 100% and 6 months angiographic follow-up rate was 74.2%, respectively.The incidence of MACE was 8.7% which including target lesion revascularization (TLR).No cardiac death and no fatal myocardial infarction were found.Conclusion: Implantation of SES for very long target lesions seemed to be safe and effective in patients with ST elevated myocardial infarction.Its long-term safety and effectiveness should be further investigated.

OBJECTIVETo compare the ettect and side-ettect of fluoxetine and combination of fluoxetine and Chinese or Tibetan medicine in treating senile depression in plateau district. Methods Ninety patients with diagnosis of senile depression conformed to CCMD-3 standard, in plateau district of 2260 - 3200 m altitude were randomly divided into three groups and treated with fluoxetine (group A), fluoxetine plus Sanpu Xinnao Xin granule (group B) and fluoxetine plus Xiaoyao pill (group C), respectively, 30 cases in each group. Therapeutic effects were evaluated with Hamilton' s depressive scale (HAMD) and treatment emergent symptom scale (TESS) after 6 weeks treatment.

RESULTSThere was no significant difference in the therapeutic effects between the three groups. The adverse reaction in Group B and C was less than that in Group A (P<0.01). Conclusion Sanpu Xinnao Xin granule and Xiaoyao pill can raise the tolerance of patients with senile depression in plateau area against the adverse reaction of fluoxetine.

Aged ; Altitude ; Antidepressive Agents, Second-Generation ; therapeutic use ; Depressive Disorder ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fluoxetine ; therapeutic use ; Humans ; Middle Aged ; Phytotherapy ; Serotonin Uptake Inhibitors ; therapeutic use

Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P＜0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P＜0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P＜0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P＞0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.

It is believed that the fundamental pathogenesis of the connective tissue diseases-associated interstitial lung disease （CTD-ILD） is kidney essence deficiency， with lung collateral obstruction throughout the disease， and environmental toxin pathogen is the important causative factors for the development of CTD-ILD. This article proposed to restore origin and alleviate bi （痹） for CTD-ILD， for which restoring origin means tonifying the lungs， spleen and kidneys to bank up the roots and consolidate the original qi， with modified Erxian Decoction （二仙汤） plus Liu Junzi Decoction （六君子汤）； alleviating bi means expelling wind and dredging collaterals， and eliminating the mass to restore the smoothness of the lung collaterals， with paired medicines of Chuanshanlong （Dioscorea nipponica）-Dilong （Kalanchoe pinnata）， Vinegar-processed Sanleng （Sparganium stoloniferum）-Vinegar-processed Ezhu （Curcuma zedoaria）， and stem-type medicines， and emphasized on removing the environmental toxin pathogens to facilitate the recovery of healthy qi.

Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection.Simple involvement of the third branch of trigeminal nerve was rare,and so were oral complica-tions such as pulpitis,periodontitis,spontaneous tooth loss,bone necrosis,etc.This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis.We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago,and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication.A few days later,he developed gum pain in the left mandibular posterior tooth area.He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure.Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening.Visible herpes zoster pigmentation and scarring on the left side of the face appeared.The left mandibular posterior tooth was missing,the exposed bone surface was about 1.5 cm x0.8 cm,and the surrounding gingiva was red and swollen,painful under pressure,with no discharge of pus.The re-maining teeth in the mouth were all m degree loosened.Imageological examination showed irregular low-density destruction of the left mandible bone,unclear boundary,and severe resorption of alveolar bone.The patient was diagnosed as left mandibular osteonecrosis.Under general anesthesia,left mandibular le-sion exploration and curettage+left mandibular partial resection+adjacent flap transfer repair were performed.The patient was re-exmained 6 months after surgery,there was no redness,swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced.Unfortu-nately,the patient had complications of postherpetic neuralgia.This case indicate that clinicians should improve their awareness of jaw necrosis,a serious oral complication of trigeminal zoster,and provide ear-ly treatment.After the inflammation was initially controlled,surgical treatment could be considered to remove the necrotic bone,curettage the inflammatory granulation tissue,and extraction of the focal teeth to avoid further deterioration of the disease.