Islet transplantation is effective in treating diabetes, however, its clinical use is highly restricted by a series of influencing factors. This review elucidates the non-immune factors including islet purification, instant blood-mediated inflammatory response and revascularization deficit on the development of islet transplantation, and also highlights the application and perspective of islet xenotrasplantation in the treatment of diabetes.

According to the theory of in vitro radioassay, using TSHAb as binder and 125I-staphylococcal protein A (125I-SPA) as tracer agent, a new method for detecting the abnormal immunoglobulin (aIgG) in the sera of patients with Graves disease (GD) was reported. In the initial study of the method, the most appropriate interacting conditions of TSHAb with aIgG were explored and compared with ELISA using ganglioside (GLS) as a binder. The relationship between aIgG and thyroid-stimulating imunoglobulin(TSI) was probed into. The results showed that TSHAb could interact specifically with aIgG in vitro; but it could not interact with IgG from sera of normal subjects, systemic lupus erythematosis (SLE) patients and diabetic patients. With aIgG as an evaluating index, the mean value in 29 normal subjects was 1. 06?0. 17. When the sera of 72 patients with GD in different clinical stages were studied, the aIgG index was positive in 83% of untreated GD patients (n = 24), in 12% of GD patients in clinical remission (n = 25) and in 82% of relapsed GD patients (n = 23). Very significant difference was observed between normal subjets and untreated and relapsed patients with GD (P

Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

Objective To evaluate the feasibility of the diagnosis of the early immunologic rejection after xeno-islet transplantation by MR imaging enhanced with superparamagnetic iron oxide(SPIO)marking CD4+T cell antibody.Methods Two thousand neonatal porcine islets(NPI)were transplanted under the left renal capsule of BALB/C nude mice.When the grafts could be observed bv MRI.107 human PBMC was intraperitoneal injected to nude mouse models to reconstitute the human immunologic system,20 mice were reconstituted.Before and 3,7,14 days after reconstitution of human immunologic system on BALB/C nude mice,MRI imaging Was performed half an hour after intravenous injection of nano-immunomagnetic beads via vena caudalis to observe the grafts'MRI signal.BALB/C nude mice were sacrificed after MRI scanning immediately,the histopathologic examination was assessed on grafts,the results were compared with MRI results.And calculate the sensitivity,specificity,Youden index number and coincidence of the MRI for immunologic rejection.Results Grafts can be observed bv MRI 3 weeks after islet cell transplantation (before immunologic rejection modeling),there is no abnormal MRI signal detected in nude mice'graft region after mierobeads injected.Seven days after building of immunologic rejection model,MRI hypo-signal in graft site is shown in the T2 WI sequence after nano-bioprober injected.Histopathologic assessments were employed on grafts in nude mice immediately(HE and immunohistochemistry staining),the results shown that there are a lot of T lymphocyts infiltrated in graft region.implying the occurrence of immunologic rejection.And the sensitivity,specificity,Youden index number and coincidence is:(72.96±0.24)%,100%,0.73±0.24,(88.46±0.13)%respectively.The correct Kappa between the MRI and the imunohistochemistry staining was 0.76.Conclusion The cellular immunological rejection to xeno-islet grarts can be assessed with nano-bioprobe with anti-CD4+ antibody MR imaging,real time,and noninvasively.

Objective To report experience of endovascular aneurysm repair (EVAR) with Endurant stent-graft for abdominal aortic aneyrysm. Methods Between May,2010 and May,2011,19 patients underwent EVAR with Endurant stent-graft at Department of Vascular Surgery,Peking Union Medical College Hospital. Clinical and morphological characteristics, operative result, peri-operative complications and follow-up data were reported. Results Procedures were successful in all these 19 cases,among those 9 were with complicated anatomical alterations.There were no type Ⅰ,Ⅲ and Ⅳ endoleak found immediately after procedure,while 4 cases were found with type Ⅱ endoleak. Major adverse event during the 30-days after operation included:consumption coagulopathy,myocardial infarction combined with heart failure,wound infection or hematoma.All cases were followed-up from 1 to 12 months. No death occurred.Eight cases had at least one CT angiography.Five cases showed aneurysm shrink,the remaining 3 cases showed aneurysm diameter did not change.One case suffered from occlusion of unilateral iliac limb artery obliteration,and was treated by fem-fem graft bypass.One case had secondary type Ⅰ B endoleak,without increase of aneurysm diameter. Conclusions EVAR with Endurant stent-graft is safe and effective.Some complicated anatomic cases could be treated successfully with Endurant stent-graft.

Objective To determine the feasibility and accuracy of velocity propagation within main pulmonary artery(VP)from color M-mode Doppler imaging using custom software on a personal computer for noninvasive estimation of PVR.Methods Color M-mode imaging of pulmonary flow was obtained and then transferred to computer,the velocity propagation of pulmonary flow was automatically obtained.Comparative studies among Doppler echocardiography,personal computer and cardiac catheterization for predicting PVR had been done in 20 children with congenital heart disease and 20 normal children.Results Velocity propagations of children with congenital heart disease were significant lower than those of normal children obtained by color Mmode echocardiography[(38.38±18.89)cm/s VS(80.34±15.65)cms,P＜0.01),and correlated well with invasive PVR measurements(r=-0.69,P＜0.01).The correlation and repeatability of VP obtained by the custom software were better than VP obtained by Doppler echocardiography(r=-0.78,P＜0.01).A VP cutoff value obtained by the custom software of 35.910 had a sensitivity of 92.9% and a specificity of 100% to within pulmonary artery obtained by color M-mode echocardiography using custom software on a personal computer.

China ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Pregnancy ; Premature Birth ; epidemiology ; Risk Factors

Objective To evaluate the extra-anatomic bypass surgery for aorto-iliac occlusive disease in the elderly. Methods From January 2005 to December 2008,33 elderly patients/39 limbs (age ranged from 70 to 87 years, mean 76.0 ± 3.0 years) with aortoiliac occlusive disease were retrospectively analyzed. According to Fontaine classification, there were 5 phase Ⅱ b cases (7 limbs), 22 phase Ⅲ cases (26 limbs), and 6 phase Ⅳ cases (6 limbs), all cases were with TASC C, D lesions. Results These 33 cases/39 limbs were tr eated with a variety of bypass, including axillobifemoral bypass (6 cases/12 limbs) ,axillofemoral bypass ( 20 cases/20 limbs ), femorofemoral bypass ( 7 cases/7 limbs ). Intermittent claudication improved in 5 cases, rest pain disappeared in 22 cases, and ulcers healed in 6 cases after operations. The mean ABI increased from 0.29 ± 0.11 to 0.66 ± 0.13 ( t = 2.69, P ＜ 0.05 ). All limbs were salvaged and there was no perioperative mortality within 30 days after operations. Postoperative complication rate was 9.1%. Patients were followed up for a median of 12 ±5 months (range, 6 to 28 months), primary patency rate was 89.7% (35/39), secondary patency rate was 94.9% (37/39), limb salvage rate was 92.3% (36/39). After dischargement the mortality was 6.1% (2/33) with one dying of myocardial infarction and another one of malignant tumor (gastric cancer). Conclusions Extra-anatomic bypass for aorto-iliac occlusive disease in the elderly is feasible, safe and effective, and the cardiopulmonary dysfunctions are the major risk factors for perioperative complications.

Objective To discuss the strategies of prevention and treatment for complications of endovascular therapy in aortoiliac artery occlusive disease.Methods 220 cases who received endovascular interventions with aortoiliac artery occlusive disease were retrospectively reviewed from June 2012 to June 2014.Among these patients,189 cases were males.The age was between 46 to 85yrs and the average age was 64yrs.Results The overall technique success rate was 97.2％.Nine procedure-related major complications requiring additional endovascular or surgical treatment were encountered in 7 patients including 2 acute in-stent thrombosis,1 iliac artery rupture,1 distal embolism,and 5 puncture associated complications (2 acute artery thrombosis,1 arteriovenous fistula,1 hematoma,1 artery dissection).8 cases improved after second endovascular or remedial open surgery,among those 4 cases were managed by endovascular interventions including 2 catheter directed thrombolysis,1 cover-stent implantation and 1 balloon-based angioplasty,4 patients received open surgery including 3 thrombectomies,1 hematoma cleating.After 22 months follow-up,the primary patency,assistant-primary patency and secondary patency was respectively 90.8％,92.1％ and 99.2％.Conclusions More attentions should be paid to the complications of endovascular therapy in aortoiliac artery occlusive disease.Helpful to prevent these complications are a comprehensive evaluation of the lesions,and individualized surgical plan prior to the operations,and a careful intraoperative management.

Objective:To study the clinical efficacy of botulinum toxin type A injection in the treatment of upper facial dynamic wrinkles.Methods:A total of 35 patients with upper facial dynamic wrinkles treated in our hospital from February 2016 to October 2016 were selected as research objects.All the patients were treated with botulinum toxin type A.The excellence rate of 30min after treatment,3 d after treatment and 7 d after treatment were evaluated and compared.The facial wrinkles severity index of the patients were evaluated by the facial wrinkles scale (FWS),and the differences of the FWS index before treatment,4 weeks after treatment and 6 months after treatment were compared.The adverse reactions,like upper facial tension,fatigue and local injection of ecchymosis after treatment were observed and compared.Results:The excellence rate of the patients after treatment of 30 min,3 d and 7 d were gradually increased.The excellence rate of the patients after treatment of 3 d and 7 d were significantly higher than that of after treatment of 30 min,and the excellence rate of the patients after treatment of 7 d were significantly higher than that of after treatment of 3 d (P＜0.05).The FWS index of the patients after treatment of 4 weeks and 6 months were significantly lower than those of before treatment,and the FWS index of the patients after treatment of 4 weeks were significantly lower than that of 6 months after treatment(P＜0.05).After treatment,only 4 patients had slight discomfort and all of these symptoms were disappeared after 3-4 days,there was no effect on their normal work and life.Conclusion:Botulinum toxin type A injection has a remarkable clinical curative effect in the treatment of patients with upper facial dynamic wrinkles,can maintain tor a long time,and also has good safety,it is worthy clinical application.