Objective To evaluate the clinical value of two-hour post-dose cyclosporine (CsA) level (C 2) monitoring in renal transplantation (RTx) recipients with functional renal allograft more than one year.Methods 126 RTx recipients with functional renal allograft more than one year treated with CsA-microemulsion-based triple therapy immunosuppression were enrolled. Whole blood samples were collected 2?h after CsA administration and the CsA level was measured by fluorescence polarization immunoassay (TDx).Results C 2 levels at 3 month and 1 year following RTx were 0.830 ? 0.307 ??mol/L and 0.678 ? 0.306 ??mol/L respectively, average C 2 level between 1 to 5 years was 0.609 ? 0.195 ??mol/L,and after 5 and 10 years, C 2 levels decreased to 0.546 ? 0.163 ??mol/L and 0.547 ? 0.227 ??mol/L respectively. Adequate C 2 level in the first 5 years after RTx was correlated with improved allograft renal function and there was a significant relationship between C 2 level and CsA dose. Variation of C 2 level became greater in long-term survival RTx recipients.Conclusion In long term maintenance phase of RTx recipients, C 2 concentration was also useful in the CsA therapeutic monitoring, but the variation became greater in such patients.

Objective To investigate clinical significance of the changes in the peripheral blood T lymphocytes subsets in patients with diseases related to HBV infection .Methods 257 cases of inpatients and outpatients were selected from Jan .to Dec .2013 ,and were divided into hepatitis B carriers (ASC)group ,chronic hepatitis B(CHB)group ,hepatocirrhosis(LC)group and primary liver cancer(PHC)group according to types of diseases related to HBV infection .Other 50 healthy individuals conducted physical exami‐nation were enro1led in the control group .The absolute CD3+ ,CD4+ and CD8+ T‐cell count ,and CD3+ ,CD4+ and CD8+ percent‐age and CD4+ /CD8+ value were detected in all subjects by using flow cytometer .These data were compared and analyzed .Results Compared with the control group ,there were no significant differences of the absolute CD3+ ,CD4+ and CD8+ T‐cell count ,and CD3+ ,CD4+ and CD8+ percentage and CD4+ /CD8+ value in ASC group ,CHB group and LC group(P>0 .05) .Compared with the control group ,the absolute CD4+ T‐cell count ,CD4+ percentage and the CD4+ /CD8+ value were decreased in the PHC group , while the CD8+ percentage were increased in the PHC group ,there were statistical significant differences between the two groups (P<0 .05) .Conclusion The peripheral blood T lymphocyte subsets could be monitor indexes of cell immune function in diseases related to HBV infection .

Objective To investigate the clinicopathologic features of sclerosing polycystic adenosis(SPA)of salivary gland.Methods The clinical and pathologic profiles of 2 SPA cases were evaluated.Immunohistochemical study was performed on fixed tissues.The biologic behavior was analyzed with follow-up data.Results The main clinical manifestation of patients was parotid painless nodules.Histological features were embedded cystic dilatation of ducts and alveoli as hyaline sclerosis collagen tissue background,catheter see apocrine metaplasia,focal areas of ductal epithelial hyperplasia and dysplasia.Immunohistochemical staining for calponin and SMA staining showed that the catheter had a layer of myoepithelial cells.Conclusion Sclerosing polycystic sialadenopathy of parotid is a rare disease,the cause and course of the disease are not very clear,but the literature reports are atypical ductal epithelial remarkable phenomenon,thus strengthen the follow-up to patients.

Objective To explore the expression of methyl CpG binding protein 2 (MeCP2) in gastric cancer tissues and its role in multi-drug resistance (MDR) in gastric cancer cells.Methods The expression of MeCP2 in 90 gastric cancer tissues and the adjacent normal tissues was detected by immunohistochemistry,and the relationship between MeCP2 expression level and clinicopathological parameters was analyzed.The expression level of MeCP2 in gastric cancer cell line SGC7901,MDR cell variants SGC7901/doxorubicin hydrochloride(ADR) and SGC7901/vincristine(VCR)was determined by Western blot.After the expression of MeCP2 was silenced by short interference RNA (siRNA),half inhibitory concentration (IC50) of 5-fluorouraeil and cisplatin in gastric cancer cell was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide(MTT) assay.The t test or chi square test was performed for statistical analysis.Results The positive rate of MeCP2 expression in gastric cancer tissues was 72.2％ (65/90),which was significantly lower than that in adjacent normal tissues (93.3％,84/ 90),and the difference was statistically significant (x2 =14.068,P＜0.01).MeCP2 expression was not correlated with age,tumor maximum diameter and lymph node metastasis (all P＞0.05),however which was related to gender,clinical TNM stages and distant metastasis (x2=4.680,4.186 and 4.327;aH P＜ 0.05).The gray scale ratios of MeCP2/β-actin in SGC7901/ADR and SGC7901/VCR were 0.593 7 ± 0.030 5 and 0.651 2 ± 0.018 6,which were lower than that of parental SGC7901 cells (1),and the differences were statistically significant (t =23.080,17.360;both P ＜ 0.01).After the expression of MeCP2 was silenced by siRNA,the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with MeCP2 specific siRNA were (11.540 0±0.469 3) μg/mL and (2.273 0±0.265 4) μg/mL,which were higher than the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with non-related oligonucleotide sequence ((8.663 0±0.160 1) μg/mL and (0.884 0 ±0.038 6) μg/mL),respectively.The differences were statistically significant (t =15.380 and 8.153;both P ＜ 0.01).Conclusions The expression of MeCP2 in gastric cancer tissues significantly decreased,which was correlated with clinical stages,distant metastasis.MeCP2 can inhibit the MDR of gastric cancer cell,which indicated the dysregulated expression of MeCP2 might participate in the genesis and development of gastric cancer.

ObjectiveTo summarize the nursing measures for patients with nasal facial soft tissue defect treated with transplantation of free foot skin flap.MethodThe clinical data of 13 patients with transplantation were reviewed to summarize the nursing measures.ResultAll skin flaps of the 13 patients survived.ConclusionEnough preoperative preparation,active psychological nursing and careful postoperative observation are critical for the success of the operation.

Artery cannulation is one of the clinical skills that should be mastered by the internships of anesthesiology. In consideration of its invasiveness,teachers should carry out the clinical teaching strictly and patiently,and assist the internships to establish a correct opinion on clinical practice. We should train the internships step by step,improve their success rates on artery cannulation and avoid complications as far as possible.

Objective To investigate the feasibility of quantitative measurement of fat concentration by CT spectral imaging in a mice model of fatty liver.Methods Twenty-four mice with different degrees of fatty liver underwent CT spectral imaging.CT values of liver parenchyma under mixed X-ray energy and 65 keV,fat concentration based on various basic material pairs (fat/water,fat/io-dine,fat/calcium)and spectral curves were obtained.Liver specimens were obtained to measure the concentration of triglyceride , and HE staining was performed.Correlations between various CT indexes and triglyceride concentration were analyzed.Results Correlation between fat concentration (fat/water pair)and triglyceride (r =0.91 5 )was better than that between CT values on 65 keV and triglyceride (r=-0.858),as well as polychromatic CT values (r=-0.81 6).All the P values were<0.001.Correlations between fat concentrations based on fat/iodine or fat/calcium pairs and triglyceride were relatively low (r=-0.726,-0.660).CT indexes on 1.25 mm slice thickness performed better than those on 2.5 mm.With fatty liver degree increased,the shape of spectral curve changed gradually.Conclusion Liver fat concentration can be measured by CT spectral imaging noninvasively,accurately and quantitatively in a mice model of fatty liver.

Objective To measure the femoral head-neck ratio among Chinese adults in Nanjing to explore its clinical significance. Methods 468 Chinese without hip symptoms were chosen randomly. There were 313 males and 155 females. 13 cases were less than 20 years old, 88 cases were from 21 to 30 years old, 123 cases were from 31 to 40 years old, 104 cases were from 41 to 50 years old, 102 cases were from 51 to 60 years old, 24 cases were from 61 to 70 years old, 14 cases were more than 71 years old. The mean age was 42.4 years old (ranged from 17 to 82 years old). The maximum diameter of the femoral head and the minimum vertical diameter of femoral neck length on both sides were measured by Digimizer software in the standard anteroposterior pelvis film. The femoral head-neck ratio (FHNR) was calculated and compared with that of the western. Results The normal FHNR of Chinese in Nanjing was 1.48 ± 0.09 (1.33-1.69). FHNR was 1.46±0.09 in Chinese aged less than 20 years old. It was 1.48±0.09 in Chinese aged from 21 to 30 years, and 1.47±0.10 in those aged 31-40 years, 1.46±0.09 in 41-50 years, 1.49±0.10 in 51-60 years,1.48±0.08 in 61-70 years, 1.49±0.10 in those more than 71 years. There was no difference between male and female, the left and right side or the different age groups. There was no difference between the western and Chinese in Nanjing. Conclusion FHNR measurement has not variation with regard to sex, age and side. It may be useful to understand some kind of the hip diseases.

Objective To evaluate whether recombinant human erythropoietin (rh-EPO) could increase the angiogenic responses in preterm rat models with periventricular white matter damage (PWMD).Methods Three-day postnatal rats were divided into 3 groups randomly:the sham group,the hypoxic-ischemic (HI) group and the recombinant human erythropoietin(rh-EPO)treatment group.Rat pups underwent permanent ligation of the right common carotid artery followed by 60 mL/L O2 for 4 h or sham operation and normoxic exposure.Immediately after the HI,rats received a single intraperitoneal injection of rh-EPO (5 U/g)or saline.Angiogenesis-related cells (CD34 + cells),microvessel density (MVD)and arteriovenous related genes (ephrinB2 and EphB4)were examined at 48 h and 96 h after operation.Results At 48 h after operation,the proteins of CD34 in HI rats increased compared with the sham rats (HI group vs Sham group:0.54 ± 0.05 vs 0.42 ± 0.05,P ＜ 0.05).However,the MVD,the mRNA of ephrinB2 and EphB4 did not change (P ＞ 0.05).The proteins of CD34,the mRNA of ephrinB2 and EphB4 increased after rh-EPO treatment compared with HI rats.However,the MVD did not increase.As the proteins of CD34 increased further at 96 h after operation (HI group vs Sham group:0.85 ± 0.06 vs 0.62 ± 0.06,P ＜ 0.05),the MVD (3.14 ± 1.21 vs 1.50 ± 1.04),ephrinB2 (7.51 ± 1.89 vs 1.28 ± 0.24) and EphB4 (4.58 ± 0.82 vs 1.21 ± 0.22) also increased (all P ＜ 0.05).And the proteins of CD34 increased after administration of rh-EPO(EPO group vs HI group:0.98 ± 0.07 vs 0.85 ± 0.06,P ＜0.05) and MVD(EPO group vs HI group:4.71 ± 1.38 vs 3.14 ± 1.21,P ＜0.05) were increased after administration of rh-EPO.However,the ephrinB2 and EphB4 did not increased after administration of rh-EPO at 96h time point.Conclusion Endogenous regenerative response is triggered in the damaged tissues and rh-EPO increases the angiogenesis in model rats with PWMD.

Objective To discuss the difference of cognitive function in patients of first-episode schizophrenia with and without metabolic syndrome.Methods Event related potential detection and Wechsler Memory Scale (WMS) was determined in 57 patients of first-episode schizophrenia with metabolic syndrome (research group) and 57 patients of first-episode schizophrenia without metabolic syndrome (control group),and the psychiatric symptom in two groups was assessed by the application of the positive and negative symptoms scale (PANSS).Results The memory quotient score was (78.51 ± 12.54) scores in research group,and (92.01 ± 17.49) scores in control group,and there was significant difference between two groups (t =-2.130,P=0.047).The short-term memory,instantaneous memory impairment in research group were lower than those in control group(t =2.151-3.054,P=0.007-0.046).The latency of P300 was (325.10 ±22.46) ms in research group and (284.60 ±22.46) ms in control group,and there was significant difference (t =3.454,P =0.003).The amplitude was (6.56 ± 1.61) μ V in research group and (9.78 ±1.73) μV in control group,and there was significant difference (t =-4.307,P =0.000).Conclusion The patients of first-episode schizophrenia with metabolism syndrome has more severe cognitive impairment than those without metabolism syndrome.