AIM: To evaluate the therapeutic efficacy and safety of heavy silicone oil (HSO), Densiron 68, was used as internal tamponade to treat complex vitreoretinopathy.METHODS: A retrospective study of 30 patients (30 eyes) who underwent vitrectomy and HSO tamponade for complex retinal detachment between January 2015 and January 2016.The best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal reattachment and complications after surgery were observed.RESULTS: There were statistical significances in both the BCVA difference between pre-operation and HSO tamponade, and the BCVA difference between pre-operation and the removal of HSO for 3mo (z=-2.198, P=0.028;z=-2.682, P=0.007).The average intraocular pressure of HSO tamponade group was 20.233±8.007mmHg, and the average intraocular pressure of pre-operation group was 16.067±4.025mmHg, showing significant difference(t=-2.913, P=0.005).Between the pre-operation group and the HSO removed group 14.933±3.423mmHg, there was no significant statistical difference in the analysis of IOP (t=2.635, P=0.430).Anatomical success was achieved in 90% of cases after the removal of HSO.Most common complications were cataract formation and oil emulsification.CONCLUSION: Densiron-68 is a safe and effective tamponade material for the treatment of complex vitreoretinopathy.However, most common complications are cataract formation and oil emulsification.So clinicians should strictly handle indications and usage during the clinical applications.

Objective To analyze the feature of B cell epitope of soluble liver antigen(SLA) in autoimmune hepatitis. Methods Twenty-one autoimmune hepatitis(AIH) were enrolled the study. The control groups included 15 primary biliary cirrhosis(PBC) patients, 20 chronic virus hepatitis patients and 20 heaths. The serum incubated with coated one dimension of SLA peptide pools by ELISA for mapping the B cell epitopes. ELISPOT was performed to screen the SLA specific T cell response by observing the secretion of IFN-γ after PBMC simulated. Results Ten serum samples from AIH patients recognized the SLA peptide pools, the frequency was 47.62%, which was higher than PBC group, virus hepatitis group and normal control group, P value was 0.001, <0.001 and <0.001, respectively. The 10 positive serum dominant response to SLA 7 th pool(aa385-441), which laid in the unique no conservative region of the SLA molecular. T cell recognizing regions laid dominantly in first and second pool, the frequency was 30% and 40%, respectively, however the recognized frequency of 7th pool was 10%. Conclusion B cell linear epitopes lie in the sequence aa385-441, which is the unique unconservative region in the high conservative SLA molecular and overlaps with part sequence of T cell epitopes. The results show it is complex and interaction that SLA induced humoral-mediated immunity and cellular immunity to involve in AIH pathogenesis.

The chemical constituents from Euphorbia lunulata was investigated in this paper. Fourteen compounds were isolated and purified by column chromatographies on silica gel and preparative HPLC. Their structures were identified by physiochemical properties and NMR data analysis as lupeol (1), euphol (2), cassipourol(3) , 24-methylenecycloartan-3beta-ol (4), 24-hydroperoxycycloart-25-en-3beta-ol (5), 25-hydroperoxycycloart-23-en-3beta-ol (6), betulin (7), uvaol (8), (23E) -25-methoxycycloart-23-en-3beta-ol (9), (23E) -cycloart-23,25-dien-3beta-ol (10), 24-methylenecycloartan-3beta, 28-diol (11), salicinolide (12), 2alpha, 3beta, 5alpha, 9alpha, 15beta-pentaacetoxy-11,12-epoxy-7beta, 8alpha-diisobutyryloxyjatropha-6 (17) -en-14-one (13) and 3beta, 5alpha, 15beta-triacetoxy-7beta-isobutyryloxy-9alpha-nicotinoyloxyjatropha-6 (17), 11(E)-dien-14-one (14). Among them, compounds 1-11 were isolated from E. lunulata for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Stereoisomerism

Objective To explore the responses of antigen-specific T cells stimulated by hepatitis B virus(HBV)-specific proteins in chronic hepatitis B patients accepting antiviral therapy. Methods Seventeen patients with chronic hepatitis B (CHB) accepting antiviral therapy were included in this study. The peripheral blood monocular cell ( PBMC) were separated from the whole blood collected at the three different time of before and one and three months after accepting antiviral therapy. ELISPOT assay was used to detect the frequency and strength of secreting IFN-γ cells of PBMC stimulated by HBsAg, HBcAg and HBeAg. HBV virus loading, HBsAg, HBeAg, ALT and AST in serum were detected at the same time. Results After three months therapy, ALT, TBiL were improved in all patients, and HBV DNA level were dropped and undetectable in 11 cases. The rates of T cell response in patients to HBV specific proteins were 64. 7% , 76. 5% and 82. 4% at the time of before and one and three months after accepting antiviral therapy, respectively. The frequency of responses of antigen-specific T cells stimulated by HBcAg was higher than that stimulated by HBsAg or HBeAg, and the frequency was enhanced after antiviral therapy. The average response magnitude was expressed as spot forming cells (SFC) per million input cells. SFC of T cell responses to HBcAg was also higher than to HBsAg or HBeAg. There was no significant difference in SFC of T cell responses to HBsAg or HBeAg at the time of before and after antiviral therapy, but there were significant difference in SFC of T cell responses to HBcAg at the time of before and after antiviral therapy. SFC of T cell responses to HBcAg was negatively associated with HBV DNA, and no associated with level of ALT in serum. Conclusion The responses of antigen-specific T cells were improved in CHB patients accepting antiviral therapy which associated with the decrease of HBV DNA. It suggested to investigate HBV specific T cell responses was important.

OBJECTIVETo explore the clinical application characteristics of sural neurocutaneous island flaps.

METHODSSural neurocutaneous island flaps were used to repair the skin defect accompanied bone and tendon exposure in the lower leg, around the ankle and foot in 21 cases, including 4 cases to repair the foreside of the foot back . Direct flap was used in 5 cases and reverse flap in 16 cases. Meanwhile the coverage and formation of sural nerve were surveyed together with the starting point of peroneal perforator.

RESULTSAll the 21 sural flaps were survived, including sural nerve (18 cases) anastomose 12 cases, single trunk 4 cases, double trunk 2 cases. The anastomose site of medial sural cutaneous nerve and the communicating branch of lateral sural cutaneous nerve was at the point of 11 - 14 cm above the ankle in 12 cases. The lower was the anastomose site, the shorter was the sural nerve. The site is 4 - 7 cm above the ankle in 15 out of 18 sural nerve perforator branch cases, and the other 3 cases is 10, 11, 11.5 cm above the ankle respectively.

CONCLUSIONSSural neurocutaneous island flaps are easy to separate. Major arteries are not injured. It is the ideal flap to repair the skin defect accompanied by bone and tendon exposure in lower leg, around ankle and foot. The nerve must be anastomosed when repairing the heel.

Adult ; Aged ; Arteries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin Transplantation ; Sural Nerve ; surgery ; Surgical Flaps ; blood supply ; innervation ; Young Adult

OBJECTIVETo explore the clinical application of the expanded cross-leg flap for repairing instep soft tissue defects with bone exposure.

METHODSThe expanded cross-leg flap was used to repair instep defects in 10 patients. After flap transferring the donor site was closed directly without skin grafting.

RESULTSSatisfactory results were achieved in all the cases. The flaps survived well. The donor site had less scar and kept good appearance.

CONCLUSIONSThe expanded cross-leg flap is a better choice for repairing the soft tissue defects of the instep. It is simple and easy with less trauma to the donor site. After the operation, both the recipient and the donor areas had good appearance.

Adult ; Aged ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Tissue Expansion ; Young Adult

OBJECTIVETo investigate polymorphisms of killer cell immunoglobulin-like receptor gene (KIR) in renal transplant recipients from southern Zhejiang.

METHODSKIR genotypes were analyzed by PCR-SSP in 416 renal transplant recipients, and the genotype frequencies were compared with populations from Eastern China and worldwide.

RESULTSAll 16 known KIR genes were detected in the renal transplant recipients, and KIR2DL4, 3DL2-3, 3PD1 were found in all. As a pseudogene, 2DP1 has a high genotype frequency (99%). The frequencies of KIR2DL1, 2DL3, 3DL1, 2DS4 have ranged from 92.1% to 98.8%. Compared with 11 groups in Eastern China and other countries, the KIR2DL2 phenotype frequency was higher (34.6%) than those of Shanghai, Zhejiang and Jiangsu populations (P<0.05). Among 41 genotypes, three have not been reported previously. The most common genotype was AA1, with a frequency of 43.51%, which was significantly lower than those of Jiangsu and Northern Zhejiang.

CONCLUSIONRenal transplant recipients from southern Zhejiang share similar features with Eastern China Han population with regard to KIR polymorphisms, but also have unique frequencies for KIR genotypes.

Adolescent ; Adult ; Aged ; China ; Female ; Gene Frequency ; Genotype ; Humans ; Kidney Transplantation ; methods ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptors, KIR ; genetics ; Young Adult

Aim To explore the effects of prenatal caf-feine exposure (PCE) on fetal renal growth retardation and corticosterone on the gene expression of metanephric mesenchyme stem cells.Methods Pregnant Wistar rats were administered with caffeine (30,120 mg ·kg-1) from gestational day 9 to 20.Female fetal kidney samples were collected for morphological observation and gene expression examination.The metanephric mesenchyme stem cells were harvested for cell culture,and renal related genes were detected after the treatment of corticosterone with different concentrations (250,500,1 000 μg · L-1) for 24 hours.Results Compared with the control group,the fetal kidneys in the PCE group displayed an enlarged Bowman's space and a shrunken glomerular tuft,accompanied with the repression of the gene expression of glial-cell-line-derived neurotrophic factor/tyrosine kinase receptor (GDNF/c-Ret) signaling pathway.The GDNF/c-Ret signaling pathway and angiotensin Ⅱ receptor type 1 (AT1R)/AT2R expression of metanephric mesenchyme stem cells also decreased in corticosterone groups.Conclusions PCE may induce dysplasia of female fetal kidneys.The potential mechanism is related to the repression of the gene expression of AT1R/AT2R and GDNF/c-Ret signaling pathway by PCE mediated by corticosterone in utero.

To investigate a baculovirus insect cell system for expressing an interferon alpha 2b (IFNa2b)/immunoglobulin G-4 (IgG4) Fc fusion protein, which has long-acting antiviral effects. Human IFNa2b and IgG4 Fc cDNAs were generated by molecular cloning and inserted into a baculovirus shuttle vector, which was then transposed into the DH10 Bac strain to form recombinant Bacmid-IFN/Fc. The Bacmid-IFN/Fc was transfected into High five insect cells, and expression of the IFN/Fc fusion protein was detected by Western blotting and its biological activity was assessed by the cytopathic effect inhibition method. The IFNa2b and IgG4 Fc cDNA fragments were successfully amplified by RT-PCR using human peripheral lymphocytes. After cloning into the baculovirus shuttle vector, pFastBac1, and transforming into DH10 Bac competent cells, screening identified positive clones carrying the recombinant Bacmid-IFN/Fc. A Bacmid-IFN/Fc clone was successfully transfected into the High five insect cells and packaged into the baculovirus for expression of the IFN/Fc fusion protein. Western blotting revealed that the fusion protein expression was specific, and yielded a protein of 45 kD in size. The in vitro antiviral activity of the IFN/Fc fusion protein was 580 IU/mL. A novel IFN/Fc fusion protein was successfully generated using a baculovirus insect cell system, which may prove useful for providing future experimental data for development of a new long-acting interferon to treat chronic viral hepatitis.
Animals ; Antiviral Agents ; metabolism ; Baculoviridae ; genetics ; Cell Line ; Cloning, Molecular ; Gene Expression ; Gene Fusion ; Genetic Vectors ; Humans ; Immunoglobulin Fc Fragments ; biosynthesis ; genetics ; Immunoglobulin G ; biosynthesis ; genetics ; Insecta ; Interferon-alpha ; biosynthesis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection

Objective To explore the research development of combined medication for elderly patients.Methods By reviewing the relevant lit-eratures, the status of elderly patients with drug use, pharmacokinetics and pharmacodynamic characteristics and the safety of drug use in the elderly patients with drug safety and safety issues were summarized and expounded.Results With the increase of age and physiological chan-ges, the pharmacokinetics and pharmacodynamics in elderly have changed, which affect the choice and safety of drug use for elderly pa-tients.Angiotensin converting enzyme inhibitors ( ACEI ) , benzodiaz-epines, calcium channel blockers (CCB) and sulfonylurea are commonly used in elderly common diseases, when combined with other drugs, they should be paid close attention to. Conclusion Prescription should follow the principle of rational drug use in elderly, in order to protect the safety and efficacy of medication for the elderly.