Animals ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Mouth Mucosa ; pathology ; Mouth Neoplasms ; drug therapy ; pathology ; prevention & control ; Precancerous Conditions ; drug therapy ; pathology ; prevention & control

Anion Transport Proteins ; physiology ; Hair Cells, Auditory, Outer ; physiology ; Humans

Hepacivirus ; Hepatitis C ; complications ; epidemiology ; Humans ; Lichen Planus, Oral ; complications ; epidemiology ; virology

OBJECTIVE： To determine the gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate in nasal drops without need of separation.METHODS： Gentamycin was determined via the dihydrolutidine derivatives produced by Hantzsh reaction using UV-spectrophotometry.The detecting wavelengths was 330nm.A dual-wavelength spectrophotometry was used for determination of ephedrine hydrochloride and dexamethasone sodium phosphate.The detecting wavelengths were 256.5nm and 241.6nm and the reference wavelengths were 228.4nm and 266.4nm for ephedrine hydrochloride and dexamethasone sodium phosphate,respectively.RESULTS： The average recovery rates of gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate were 100.74％ (CV=0.2％ ,r=0.9 999,n=5),100.15％ (CV=0.66％ ,r=0.9 997,n=5)and 99.46％ (CV=0.35,r=0.9 996,n=5)respectively.CONCLUSION： This method is simple,rapid,accurate and stable and suitable for rapid quality control of compound gentamycin sulphate nasal drops.

Objective:To determine distribution of fungal florae of candial balanoposthitis (CBP),the relatioship between antibiotics administration and candial infection and the major source of opportunistic pathogens.Methods:The fungal strains were collected and identified,and the history of antibiotic administration was reviewed.Results:①Foreign fungi were predominant pathogens of CBP;②Dysbacteriosis induced by antibiotics stimulated the growth of foreign fungi,which resulted in CBP;③There was a positive relationship between fungal distribution of male patients and their sexual partners.Conclusion:In order to reduce the incidence of CBP safe coition and reasonalbe administration of antibiotics should be emphasized.

Objective To review the strategies for multiple coronary artery bypass in patients with calcified ascending aorta.Methods From June 2002 to December 2007,36 patients with multiple coronary artery disease and calcified ascending aorta underwent OPCAB without aortic side-bite clamping.The patients(28 males and 8 females) aged from 60 to 83 years with a mean of(69.1?6.7) years.Fifteen of the patients had a history of stroke.Coronary angiogram revealed that 3 patients had double vessels disease and the others had triple vessels disease,involving the left main stem in 14 cases.The left ventricular ejection fraction ranged from 0.32-0.69.Calcified ascending aortic plaque can be explored in 30 of the patients during operation while intra-operative transesophageal echocardiography indicated calcified aorta only in 28.No-touch technique was used in 22 patients either with LIMA as the only inflow and the saphenous vein grafts was anastomosed to the LIMA in 15 patients,or with bilateral internal mammary arteries as the only inflows in 7 patients.Proximal anastomotic device was employed in 14 patients to finish the proximal anastomosis of greater saphenous vein grafts without aortic side-biting clamping.Intra-operative graft flow meter was used to check the flow of grafts before chest closure. Results Totally 116 cases of distal anastomosis were performed in the 36 patients(2-5 in each,mean 3.2?0.9).The patients woke up from anesthesia in 2 to 22 hours.Intraoperative measuring of graft flow revealed satisfying blood flow in all the grafts.In the 15 patients with LIMA as the only inflow,the total graft flow in the main stem of LIMA was basically the sum of each connected grafts.Only one patient died after surgery,showing a mortality rate of 2.7%.Eight patients(26.7%) had transient atrial fibrillation after the operation,2 showed pulmonary infection,4 had chest fluid,1 showed infection of the incision at the lower limb.All the complications were cured.30 patients achieved a 6-to 60-month follow-up with a mean of(33.8?11.2) months.During the period,11 patients(37 grafts) were examined by angiography,which showed that all the grafts of LIMA to LAD and vein grafts were patent,except in two vein grafts,which were occluded in the diagnol branches. Conclusions In patients with remarkable ascending aortic calcification,OPCAB combined with aorta no-touch technique or proximal anastomosis device can effectively decrease the incidence of postoperative stroke.

Objective To evaluate the condition of living renal donors with 3-dimensional volume rendering computed tomography (3D-CT) in preoperation. Methods 10 consecutive cases received hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN) from December 2001 to July. Total patients underwent 3-dimensional volume rendering computed tomography before operation for assessing the condition of the anatomical location, number, anomalies and spatial interrelationships of the renal arteries and veins. These 3D-CT were directly compare with intraoperative surgical findings at laparoscopy and the harvested kidney ex vivo to value the sensitivity and accuracy of 3D-CT. Results The CT digital data of 10 cases were reconstructed to 3D-CT with volume rendering technique, and HLDN were performed successfully in all the cases. The 3D-CT accurately identifies renal vascular anatomy. Conclusions Not only the 3D-CT accurately identifies renal vascular anatomy but also tridimensional images reconstructed by the enhanced CT digital data of arterial phase, venous phase and renal parenchymal phase are viewed by surgeon in any position. It is a manner that may facilitate renal hilar dissection during laparoscopic donor nephrectomy. The 3D-CT should be a routine examination for living donor in preoperation

Objective To study the chimerism formation in kidney transplantation recipient receiving peripheral blood stem cells (PBSCs) of the donor after the patient received preoperative total lymphoid irradiation (TLI). Methods 5 patients of living donor kidney transplantation were involved in present study. The mean age of donors was 40 and that of recipients was 27. There was one patients with 4 HLA antigen mismatches out of 6 HLA-A, B, DR antigens, two patients with 3 HLA-mismatches, and two patients with 1 HLA-mismatch. The patients received TLI in doses 90cGy/d from day -5 to day -1. The immunosuppression protocol for these patients during operation and afteroperation was similar to that for other cases, but the dosage was slightly reduced. Donor PBSCs were harvested twice via leukapheresis after the administration of human recombinant granulocyte colony stimulating factor (G-CSF). PBSCs were infused intravenously to the recipients on postoperative day 4 and 7. Chimerism of peripheral blood cell in recipients was detected by PCR-SSP assays. The grafted kidney function, acute rejection frequency and GVHD episodes were also observed. Results After 5 days of G-CSF based mobilizing regimen, the average number of PBSCs harvested from donors was 34?10~6. At 1 month post-transplantation, donor type HLA-DR gene was detected in all the recipients. At 2 and 3 months post-transplantation, chimerism was not detectable in the recipient with 4 HLA antigens (including 2 HLA-DR) mismatched donor kidney and in the recipient with 3 HLA (including 2 HLA-DR and 1 HLA-B) mismatched donor, respectively. In the other 3 recipients, chimerism was still positive 3 months post-transplantation. There were no symptoms of GVHD or infections after infusion of PBSCs. Transplanted kidneys functioned normally and no rejection episodes were observed till the end of the study. The immunosuppressant dosage was lower for these 5 cases than those after conventional cadavar renal transplantation. Conclusions Non-myeloablative TLI conditioning regimen is a safe and effective method which can promote the engraftment of donor PBSCs and induce hemopoietic chimerism. Chimerism can alleviate rejection of the transplanted kidney and reduce the immunosuppressant dosage. Collection and infusion of PBSCs are simple, convenient, effective, and inexpensive, and it is an optimal source of hemopoietic stem cells.

Objective To investigate the safety and effectiveness of the application of an immunosuppressing primed total lymphoid irradiation (TLI) of the recipient in kidney transplantation of living donor kidney graft. Methods 5 recipients, 3 males and 2 females with the average age of 27, underwent the primed regimen of TLI. As to 6 HLA-A, B, DR antigens of donors and recipients, 4 HLA antigen mismatches were found in one case, 3 mismatches in two cases, and 1 mismatch in two cases. The donor grafts were procured by the technique of hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN). The primed regimen of TLI was carried out 5 days before the operation in a dosage 90 cGy/d. The intra- and postoperative immunosuppressant protocols for these cases were similar to that for the other cases, but the doses were reduced slightly. WBC, total T cell, CD4~+ and CD8~+ T cell subsets and Th1/Th2 immune deviation were examined in recipients periodically. The function of the grafted kidney, acute rejection frequency, and side effects of TLI were also observed. Results In the recipients undergone TLI, the total WBC and T cell, CD4~+ and CD8~+ subsets were reduced to a base value at 1-2 weeks post-transplantation and did not restore to the pre-transplantation levels until the investigation was ended. A particular phenomenon showing that in TLI based regimen T cells were shifted from Th1 to Th2 cells was observed. No side effects of TLI, such as infection, were found during the observation. Transplanted kidneys functioned normally and no rejection episodes were observed up to the end of the study. The immunosuppressant doses for those 5 cases were lower than that of conventional protocol. Conclusions TLI based non-myeloablative primed regimen is a safe and effective method for immunosuppression without serious side effects, and it can markedly alleviate kidney transplant rejection and reduce the dosage of immunosuppressive drugs.

Objective To investigate the characteristics of HBsAg and HBcAg in combination pulsed monocyte-derived DCs(MoDC) derived from patients with HBV-associated hepatocellular carcinoma(HCC).Methods MoDCs were generated from 20 HBV-associated HCC patients,and pulsed with recombinant human serum albumin(rHSA)as conDC(control DC),or pulsed with HBsAg andHBcAg in combination as scDC.Phenotypic patterns of MoDCs were characterized by flow cytometry,and the levels of cytokines releasedby MoDCs were analyzed by ELISA,and frequencies of IFN-γ-producing antigen-specific autologous T cells were measured by Elispotassay.HBV-specific CD8 T cells proliferation was determined by pentamer staining.Results 1.The levels of MHC and costimulatorymolecules expressed on scDC were significantly higher than those on immature MoDC(imaDC)in two groups,and the levels of MHC andcostimulatory molecules expressed on imaDC,conDC and scDC in HBsAg+,anti-HBe+,anti-HBc+patients(1-4-5 positive group)were significantly higher than those in HBsAg+,anti-HBc+patients(1-5 positive group);2.The levels of IL-12 and IL-10 produced byscDC were higher than those produced by imaDC and conDC in both groups,and the levels of IL-12 produced by imaDC,conDC and scDCin 1-4-5 positive group were higher than those in 1-5 positive group.3.The frequencies of IFN-γ-producing T cells induced by scDC werehigher than those by conDC in 1-4-5 positive group.4.scDCs from 4 cases of HLA-A2+patients in 1-4-5 positive group could induceautologous T cells to generate HBVcore18-27-specific CD8 T cells.Condusions HBsAg and HBcAg pulse in combination couldsubstantially reverse the impaired function of MoDCs in HBv-associated HCC patients,and boost MoDC to induce HBV-specific T cellsresponse,especially in HBsAg+,anti-HBe+ and anti-HBe+ patients.