Drugs, Chinese Herbal ; adverse effects ; Humans ; Nephritis ; chemically induced ; prevention & control

Anastomosis, Surgical ; methods ; Humans ; Organ Transplantation ; adverse effects ; methods ; Postoperative Complications ; etiology ; surgery ; Vascular Surgical Procedures ; methods

Breast ; radiation effects ; Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Mastectomy ; Mastectomy, Segmental

Objective To determine the roles of MyD88 and Trif,critical adaptor proteins for TLR signaling,in production of donor-specific antibodies (DSA) and memory T cells in a presensitized mouse cardiac transplant model.Methods Skin grafts from Balb/c mice were transplanted into either wild type B6 mice or B6 Myd88 and Trif double knockout mice (Myd88/Trif DKO).The recipients were subsequently transplanted heterotopically with cardiac grafts from the same donors two weeks after skin transplantation.Plasma DSA levels and spleen phenotypical analysis were performed prior to heart transplant or at time of cardiac rejection by using flow cytometry.Results Recipients presensitized with skin grafts developed accelerated cardiac allograft rejection in the absence of Myd88 and Trif.However,plasma DSA,especially IgG2,was significantly decreased (P＜0.05) in Myd88/Trif DKO mice,compared to that in Wild Type mice at 2nd week after skin transplantation.The production of DSAs including all IgG subtypes was further reduced 3 days following heart transplantation in the Myd88/Trif DKO.In addition,MyD88/Trif DKO mice had impaired ability to generate memory T cells,as percentages of both CD44hi CD4+ and CD44hi CD8+ were significantly lower in the DKO than in Wild Type mice (P＜0.01,P＜0.05).Conclusion Simultaneous ablation of MyD88 and Trif in recipients significantly decreases the production of serum DSAs and spleen memory T cells following allogeneic skin and heart transplantation,supporting a crucial role of TLR signaling in adaptive immune responses in organ transplantation.

Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.

BACKGROUND:Compared with smooth titanium, titania nanotubes cannot only induce mesenchymal stem cels osteogenic differentiation and promote bone integration, but also be used as drug nanocarriers. OBJECTIVE:To prepare dexamethasone-loaded titania nanotube system and to test its drug release characteristics. METHODS:Titania nanotubes were prepared by electrochemical anodic oxidation, and dexamethasone was dripped onto the prepared titania nanotubes. Subsequently layer by layer self-assembly technology was employed to fabricate gelatin/chitosan multilayered structure on the prepared samples. Scanning electron microscope and contact angle test were carried out during the process of building the gelatin/chitosan multilayered structure. The drug release was measured by a ultraviolet spectrophotometer. RESULTS AND CONCLUSION:Under the scanning electron microscopy, the fabricated titania nanotubes had integral structure with even tube size of about 70 nm and arranged regularly, and the nanotubes were completely covered and sealed by the gelatin/chitosan multilayered membrane. Contact angle test results showed that ever since the fifth layer, contact angles changed alternately and displayed a zigzag profile. Ultraviolet spectrophotometer test results showed that when cultured for 3 hours, the cumulative drug release was about 32.7% and demonstrated an initial burst folowed by sustained release. When cultured for 24 hours, the cumulative drug release about 52.3%. However, after cultured for 7 days, little drug release was detected. And there was about 8.0%-10.0% dexamethasone of initial loading preserved in nanotubes.

Adult ; Cranial Fossa, Middle ; anatomy & histology ; surgery ; Ear, Inner ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; surgery ; Humans ; Male

Aged ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; pathology ; Urinary Bladder ; pathology

Objective To investigate the diagnostic and therapeutic characteristics of prostate cancer with prostate specific antigen(PSA)4-10?g/L. Methods The data of prostate biopsies for the patients with PSA 4-10?g/L from May 1998 to February 2004 and the treatment and prognosis of these patients were retrospectively analyzed. Results In the 141 cases, 34 were diagnosed as prostate cancer, including 3 cT1, 21 cT2, 6 cT3 and 4 cT4. Mean Gleason score was 5.8, and the mean Gleason scores of cT1 and cT2 were significantly lower than those of cT3 and cT4. Twenty-four cases of cT1 and cT2 underwent radical prostatectomy. Four cases of cT3 recieved radical prostateetomy after 4 months of neoadjuvant endocrine therapy. Two cases of cT3 and 4 cT4 received castration. Pathological section from radical surgeries showed that 21 cases were organ confined and 7 were locally invasive. The difference of mean Gleason score between these two groups was significant in statistics. After 18 to 69 months (mean 42 months)follow-up, 21 organ confined cases were free survived, 4 locally invasive cases had biochemical recurrence and 1 case had multifocal bone metastasis. No cancer-specific death happened. Two of 4 cT4 cases were still alive and 2 died of the tumor. Conclusions Routine needle biopsy is necessary for the cases with“grave area”PSA of 4～10 ?g/L. Prostate cancers with PSA 4～10/?g/L are not always early diseases. Gleason score is a very important index for determine the stage of pathology after surgery. Radical prostatectomy is an effective treatment for organ confined disease.

Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.