Objective To study the effect and safety of conversion from calcineurin inhibitors to rapamycin in kidney transplantation recipients with chronic allograft nephropathy.Methods In 82 kidney transplant recipients enrolled in this study,72 cases were diagnosed as having chronic allograft nephropathy by biopsy.Recipients (SRL group) were administered with rapamycin after withdrawal of calcineurin inhibitors.The doses of CNI in other recipients (non-SRL group) were not changed.Renal function,proteinuria,blood pressure,blood fat,hepatic function and hemogram were observed for 24 months in each group.Results During the follow-up period,serum creatinine level was dropped significantly in SRL group (P＜0.05),but it was increased in non-SRL group (P＜0.05).SRL group showed increased proteinuria,serum cholesterol and triglycerides (P＜0.05),and reduced Plt (P＜0.05).According to the renal function before conversion,the recipients who were administered rapamycin divided into four groups.In group A (Scr ＜ 120 μmol/L),there was no significant difference in diverse variables before and after conversion.In group B (Scr 120-200 μmol/L and Banff Ⅰ-Ⅱ),renal function was improved,and proteinuria alleviated.In group C (Scr 120-200 μmol/L and Banff ＞ Ⅱ),and group D (Scr ＞200 μmol/L),renal function was damaged to varying degrees and proteinuria was deteriorated.Conclusion It is safe and effective for patients with chronic allograft nephropathy to convert from calcineurin inhibitors to rapamycin.

Objective To study the influence of postnatal high protein feeding on learning and memory abilities of preterm rats.Methods After weaning,the SD offspring were divided into 6 groups randomly according random digits table:preterm standard protein group (group A),term standard protein group (group B),preterm low protein group (group C),term low protein group (group D),preterm high protein group (group E),and term high protein group (group F),with 34 rats in each group.Starting from 22 days of age,the standard protein group,low-protein group and the high-protein group were respectively fed with a standard protein diet (containing 18％ protein),low-protein diet (containing 8％ protein) and a high-protein diet (containing 30％ protein) until the end of experiment.Within each group,the rats were respectively tested in 6 weeks and 8 weeks.Morris water maze task was performed to assess the learning and memory abilities of the premature rats.Results 1.Directional navigation experiments:(1) At the age of 6 weeks,the escape latencies to find the platform were shortened with increased training times for full-term rats.The escape latencies of the premature rats did not change significantly on the third and fourth day of the experiment.(2) At the age of 8 weeks,the escape latencies to find the platform were shortened with increased training time for all of the rats.2.Probe trial test:(1)At the age of 6 weeks,premature rats spent significantly less time in target quadrant than full-time rats.And the percent age of traveled distance in target quadrant of premature rats was significantly less than full term rats (P ＜ 0.05).(2) At the age of 8 weeks,group E [(68.48 ± 20.65) s] spent significantly greater time in target quadrant than group A and group C [group A(52.41 ± 11.24) s,group C (49.54 ± 11.04) s].And the percent age of traveled distance in target quadrant of group E [(36.56 ± 10.44) ％] were significantly higher than group A and group C [group A (29.83 ± 8.33) ％,group C (26.97 ± 5.41) ％] (P ＜ 0.05).(3) At the age of 8 weeks,group E spent time in target quadrant and the percent of traveled distance in target quadrant [(68.48 ± 20.65) s,(36.56 ±10.44)％] were higher than group F [(61.29 ± 16.27) s,(35.71 ±6.61)％],but there was no significant difference (P ＞ 0.05).Conclusions In the early growth and development process of the brain,premature birth may seriously affect early brain functions in rats,and the learning and cognitive abilities of the premature rats are worse than full-term rats.In the subsequent process of growth and development,after a long time of high protein nutritional intake,the learning and cognitive abilities of the premature rats can be restored and they can catch up with full-term rats.

Objective To detect the changes of cellular immune level in patients with different grades of glioma in perioperative period, and to investigate its relationship with the postoperative intracranial infection. Methods A total of 53 patients with glioma newly diagnosed by pathology who underwent the surgical treatment in the First Hospital of Shanxi Medical University from September 2017 to September 2018 were collected. According to the World Health Organization (WHO) classification criteria, the patients were divided into the low-grade group (grade Ⅰ-Ⅱ, 21 cases) and the high-grade group (grade Ⅲ-Ⅳ, 32 cases). The peripheral blood at the time of 1 day before the operation, 1 day and 7 days after the operation was drawn to detect the T lymphocyte subsets, and then the differences of cell immunity indexes from different grade gliomas were analyzed. The relationship between immune level and postoperative intracranial infection was analyzed. SPSS 22.0 statistical software was used to analyze the data. Results The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the high-grade group at the time of 1 day before the operation were (54.09±4.25)％, (31.93±3.08)％, (34.23±2.48)％, (9.66±1.47)％, 0.93±0.06, respectively; the levels at the time of 1 day after the operation were (48.84±3.69)％, (27.49±2.41)％, (34.99±2.96)％, (11.09±1.70)％, 0.84± 0.05, respectively; the levels at the time of 7 days after the operation were (59.45 ±3.47)％, (33.59 ±2.66)％, (31.99±1.97)％, (7.45±1.48)％, 1.05±0.07, respectively. The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the low-grade group at the time of 1 day before the operation were (62.37±6.57)％, (34.88± 4.43)％, (30.16 ±3.75)％, (6.30 ±1.29)％, 1.16 ±0.11, respectively; the levels at the time of 1 day after the operation were (55.44 ±7.25)％, (29.05 ±4.04)％, (31.66 ±3.13)％, (7.95 ±1.67)％, 0.92 ±0.11, respectively; the levels at the time of 7 days after the operation were (67.73 ±7.18)％, (35.55 ±4.95)％, (28.10 ±3.12)％, (5.50 ± 1.25)％, 1.27±0.12, respectively. The levels of CD3+, CD4+, CD4+/CD8+before and after the operation in the high-grade group were lower than those in the low-grade group (all P< 0.05), while the levels of CD8+and CD4+CD25+Foxp3+were higher than those in the low-grade group (all P<0.05). Compared with the levels at the time of 1 day before the operation, the levels of CD3+, CD4+, CD4+/CD8+at the time of 1 day after the operation of both groups were decreased, while the levels of CD8+and CD4+CD25+Foxp3+were increased (all P< 0.05). The levels of CD3+, CD4+and CD4+/CD8+ at the time of 7 days after the operation in the both groups were increased, while the levels of CD8+ and CD4+ CD25+ Foxp3+ were decreased (all P< 0.05). Among 53 patients, 8 cases had postoperative intracranial infection, and the infection rate was 15.09％. Age, duration of surgery, pathological stage, and intraoperative blood transfusion were the independent affecting factors of postoperative intracranial infection of cerebral glioma (OR= 1.513, P= 0.024; OR= 1.722, P<0.01; OR= 1.365, P= 0.001; OR= 1.262, P< 0.01). Conclusions The peripheral blood cellular immune level of glioma patients is related with the malignancy of glioma. The inhibition degree of the cellular immunity could be relieved after the resection of glioma. The detection of T lymphocyte subsets could be considered as an evaluating index for the malignancy and prognosis in patients with glioma. The clinical detection of cellular immune can play a positive role in predicting and preventing the postoperative intracranial infection in patients with glioma.

Objective To study the influence of protein intake in learning and memory capabilities and mammalian target of rapamycin (mTOR) expression in premature rats.Methods Premature rars were randomly divided into three groups after weaning:preterm standard protein group,preterm low protein group and preterm high protein group.After weaning,three groups were respectively fed with standard protein diets (18％ protein),low protein diets (8％ protein) and high protein diets (30％ protein) until the end of experiment.When rats were at the 6th and 8th weeks,they were performed Morris water maze test to assess the learning and memory abilities,and irnmunohistochemistry and Westem blotting were used to observe the mTOR distribution and mTOR protein expression in the hippocampus.Results At the age of 6 weeks,the escape latencies of the premature rats did not change significantly on the 3rd and 4th day of the experiment; the frequency of crossing the platform and the mTOR-positive cells in hippocampal CA1 and CA3 regions of each group showed no significant differences (P＞0.05).At the age of 8 weeks,the escape latencies in finding the platform were shortened with increased training times for premature rats; the frequency of crossing the platform of high-protein premature rats was significantly higher than that in the other two groups (P＜0.05); and the mTOR expression in the hippocampal CA1 and CA3 regions of high-protein premature rats was also significantly increased as compared with the other two groups (P＜0.05).High-protein premature rats at the age of 8 weeks had significantly higher frequency of crossing the platform and increased mTOR-positive cells in the hippocampal CA1 and CA3 regions than those at the age of 6 weeks (P＜0.05).Western blotting also indicated that the hippocampal mTOR protein expression was not significantly different in each group at 6 week-old; the mTOR expression of high-protein premature rats was significantly higher than that in the other two groups at the age of 8 weeks.Conclusions In the early growth and development process of the brain,mTOR activity might be inhibited in the premature birth rats,which can lead to impaired learning and memory abilities.After a long time of high protein nutritional intake,impaired learning and cognitive abilities of premature rats can get recovery,which may be associated with up-regulation ofmTOR expression.

Objective:To explore the common risk factors of intracerebral hemorrhage(ICH) in young people and to establish a predictive model of nomogram.Methods:The relevant data of young patients with ICH (≤45 years ) hospitalized in the Department of Neurosurgery of Dezhou people's Hospital from January 2014 to August 2021 were retrospectively studied, and the young group who underwent physical examination in the Physical Examination Center of Dezhou people's Hospital at the same time were randomly selected as the control group. Analyze the risk factors that may affect cerebral hemorrhage in young people, screen the risk factors with statistical differences through single factor analysis, screen the independent risk factors according to multi factor Logistic regression analysis, construct the risk nomogram model of cerebral hemorrhage in young people, and test the efficiency, goodness of fit and benefit of the constructed model through internal validation.Results:Compared with the control group, there were statistically significant differences in family history (χ 2=115.66, P<0.001), hypertension grade( Z=17.67, P<0.001), smoking history (χ 2=33.91, P<0.001), drinking grade ( Z=4.84, P<0.001), body mass index (BMI) ( t=11.76, P<0.001), low density lipoprotein ( t=4.78, P<0.001), high density lipoprotein cholesterol ( t=5.83, P<0.001),blood glucose ( Z=5.68, P<0.001) and homocysteine ( Z=2.22, P<0.001) in the case group. Binary Logistic regression analysis showed that hypertension grade ( OR=3.457, 95%CI: 2.809-4.254, P<0.001), family history ( OR=2.871, 95%CI:1.868-4.413, P<0.001), BMI ( OR=1.093, 95%CI:1.040-1.148, P<0.001), high density lipoprotein cholesterol ( OR=0.230, 95%CI:0.111-0.480, P<0.001), blood glucose ( OR=3.457, 95%CI:2.809-4.254, P<0.001), homocysteine (O R=3.457, 95%CI:2.809-4.254, P<0.001) was an independent risk factor for intracerebral hemorrhage in young adults. The nomogram prediction model showed that BMI was 96 points, hypertension grade was 100 points, family history was 30 points, high density lipoprotein cholesterol was 76 points, homocysteine was 48 points, blood glucose was 52 points,homocysteine was 48 points and blood glucose was 52 points, respectively. The consistency coefficient of the prediction model was 0.874. The nomogram dependent ROC curve AUC was 0.891, and the corresponding sensitivity and specificity were 74.5% (263/353) and 89.7% (437/487), respectively, a nomogram model was established with good diagnostic efficiency. Conclusion:The nomogram model established in this study can predict the probability of intracerebral hemorrhage in high-risk population, and take intervention measures as early as possible to prevent the occurrence of intracerebral hemorrhage in young people.