Kidney transplantation has become the optimal treatment for end-stage renal disease. However, the demand for kidney exceeds the available supply. In last years, living-related kidney transplantation has progressively increased because of the less rejection, the higher achievement ratio and so on. From 2007 to 2008 ,our hospital succeed in 196 living-related kidney transplantation based on the previous work.

Literature of TCM contains abundant information of Chinese medicine. Traditional Chinese medicine information is characterized by its high degree of knowledge-intensive and complex inter-knowledge, so it is difficult to integrate and share knowledge. TheShanghanlun is one of the Chinese medical classics, and it includes the rules and methods of syndrome differentiation and treatment and it showed good effects in the clinical application. However, it is difficult to master for beginners. As a kind of knowledge organization tool, topic maps can flexibly define the relationship between knowledge, which realizes the visualization of knowledge network, and integrates and shares the distributed knowledge. This paper focused on the current situation of topic maps researches. The topic maps was used to organize the original content ofShanghanlun, construct the concept model of it and explore the specific application of topic maps technology in the field of traditional Chinese medicine.

Objective To explore the diagnostic value of anti-cyclic citrullinated peptide (CCP) 3.1 IgG/IgA antibody detected by enzyme-linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA).Methods The ELISA was used to measure the anti-CCP3.1 antibody in the serum of 169 RA patients,100 patients with other rheumatic diseases (including systemic lupus erythematosus,Sjogren's syndrome and osteoarthritis) and 72 healthy controls.The diagnostic value of CCP3.1 was assessed and compared with the second generation of anti-CCP IgG (CCP2) antibody,the correlations between anti-CCP3.1 antibody and the clinical and laboratory parameters were analyzed.Two-independent samples t test,chi-square test and Spearman's correlation were adopted for statistical analysis.Results ① The average cut-off concentration of anti-CCP3.1 antibody was (1122±1429) U/ml in RA,(13±14) U/ml in other rheumatic diseases and (6±5) U/ml in healthy controls.② The area under curve of ROC for anti-CCP3.1 antibody and anti-CCP2 antibody were 0.923 and 0.936 respectively.There was no difference between the sensitivity (82％ vs 79％)and specificity (97％ vs 99％) of anti-CCP3.1 antibody and anti-CCP2 antibody.The Kappa values between anti-CCP3.1 antibody and anti-CCP2 antibody was 0.763.③ We also found that anti-CCP3.1 antibody was positive in 20％(7/35) of anti-CCP2 antibody negative,43％(18/42) of RF negative,62％(47/76) of AKA negative,71％(49/69) of APF negative and 13％ of autoantibodies negative patients,indicated that antiCCP3.1 antibody had a potential value in the diagnosis of serum negative patients with RA.④ The presence of anti-CCP3.1 antibody was correlated with RF,HRF-IgG,APF,AKA,GPI and IgA (P＜0.05),except disease activity.Conclusion The sensitivity of anti-CCP3.1 antibody is slightly higher than anti-CCP2 antibody.The Anti-CCP3.1 antibody is a very valuable parameter for the diagnosis of RA,especially in serum negative patients.

Objective To explore the effects of estrogen and angiotensin Ⅱ receptor 1 inhibitor（saralasin）on cell proliferation,cell cycle and apoptosis in endometrial carcinoma cell line HEC-1A.Methods Immunocytochemical assay was applied to detect the expression of AT1-R,PI3K,p-Akt and ERK protein in HEC-1A cell.The effects of estrogen and saralasin on cell proliferation,cell cycle distribution and apoptosis of HEC-1A cell were detected by MTT assay and fluorescence activated cell sorting technique.The expression of ERK and p-Akt protein in HEC-1A cell treated with estrogen and saralasin were analyzed by Western blot.Results The expression of AT1-R,PI3K,pAkt,and ERK protein was found in HEC-1A cell.Estrogen stimulated the proliferation of HEC-1A cell,decreased G0~G1 phase proportion and increased S phase proportion significantly,minimized the number of apoptotic cells,and up-regulated the expression of ERK protein.Saralasin obviously inhibited the proliferation and induced apoptosis of estrogen induced HEC-1A cell,increased G0~G1 phase proportion and decreased S phase proportion,and down-regulated the expression of ERK protein.Conclusion Estrogen could promote the proliferation of HEC-1A cell through AT1-R.AT1-R inhibitor saralasin could inhibit the proliferation and induce the apoptosis of estrogen induced HEC-1A cell.The down-regulation of ERK protein expression by interrupting the mitogen-activated protein kinase（MAPK）signaling pathway might be involved in the possible mechanism.Thus saralasin could be a valid approach to treat ER-negative endometrial carcinoma.

Objective To investigate the correlation between opportunistic infections in patients with HIV /AIDS in Dali of Yunnan Province and CD +4 lymphocyte count,discover the incidence trend of opportunistic infections in patients with HIV /AIDS in Dali and instruct early diagnosis and treatment.Methods Choosing 454 cases of opportunistic infections in patients with HIV /AIDS in Infectious Disease Dali Prefectural Hospital were chosen,ana-lyze various opportunistic infections,examining CD +4 lymphocyte count and analyze the differences of opportunistic infections on CD +4 lymphocyte count.Results 454 cases opportunistic infections with HIV /AIDS,48.24% were HCV infections,38.72% of various tuberculosis consumption phthisis,28.41% of bacterial pneumonia and 25.77%of oral condida monilia infections,high rate of opportunistic infections when CD +4 lymphocyte count <200 /μL;when CD +4 <50 /μL,53.33% of the patients with more than three pathogen infections,thus higher than those CD +4 >350 /μL of 5.56%(χ2 =34.88,P <0.01);The high rate of opportunistic infections found on patients without the treatment of HAART(40.83%,U =9.05,P <0.01),comparing to 18.79% of those with the treatment.Conclusion The com-mon opportunistic infections in our area are HCV,various tuberculosis consumption phthisis,bacterial pneumonia and oral condida monilia infections;high rate of opportunistic infections happens when CD +4 lymphocyte count are low and lower rate on those with the treatment of HAART,offering an effective method on controlling opportunistic infections.

OBJECTIVETo summarize the features and treatment of male infertility induced by autosomal dominant polycystic kidney disease (ADPKD), and compare the outcomes of intracytoplasmic sperm injection (ICSI) for infertile men with ADPKD and those with congenital bilateral absence of vas deferens (CBAVD).

METHODSWe retrospectively analyzed 21 cases of ADPKD-induced infertility, 15 treated by ICSI (group A), and another 164 cases of strictly matched CBAVD-induced infertility (group B). We compared the two groups in the couples' age, the number of ICSI oocytes, and the rates of fertilization, transferrable embryos, good embryos, embryos implanted, clinical pregnancy, biochemical pregnancy, early abortion, singleton and twins in the first cycle.

RESULTSAfter 28 cycles of ICSI, 10 of the 15 ADPKD-induced infertility patients achieved clinical pregnancy, including 7 cases of live birth, 1 case of spontaneous abortion, and 2 cases of pregnancy maintenance. No significant differences were observed between groups A and B in the couples' age, the wives' BMI, or the numbers of ICSI oocytes and embryos transplanted (P >0.05), nor in the rates of ICSI fertilization (72.64% vs 76.17%), transferrable embryos (51.28% vs 63.24%), quality embryos (38.46% vs 49.83%), embryo implantation (17.64% vs 38.50%), abortion (0 vs 9.23%), singleton (50% vs 81.54%) and twins (50% vs 18.46%). However, the rates of clinical pregnancy (13.33% vs 42.68%, P = 0.023 <0.05) and biochemical pregnancy (13.33% vs 39.63%, P = 0.032 <0.05) were significantly lower in group A than in B.

CONCLUSIONICSI is effective in the treatment of male infertility induced by either ADPKD or CBAVD, but the ADPKD cases have a lower success rate than the CBAVD cases in an individual cycle. The affected couples should be informed of the necessity of prenatal genetic diagnosis before embryo implantation and the inevitable vertical transmission of genetic problems to the offspring.

Abortion, Spontaneous ; Embryo Implantation ; Embryo Transfer ; Female ; Humans ; Infertility, Male ; therapy ; Male ; Male Urogenital Diseases ; therapy ; Oocytes ; Polycystic Kidney, Autosomal Dominant ; complications ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Vas Deferens ; abnormalities

Objective To study the HLA match rate of 222 living-related donors for kidney transplantation, and to give suggestions for clinical selection of suitable donors and recipients. Methods We analyzed the HLA match rate of 222 kidney transplantations from living relative donors from April 2006 to December 2008. There were 168 male recipients and 54 female recipients. The ages of 222 recipients ranged from 10 to 58. There were 133 male donors and 89 female donors. The ages of 222 recipients ranged from 21 to 64.Results The HLA-A, B, DR, DR, antigens of 87 kidney transplantations from living parental donors were half-matched, of which 14 were higher than half-matched. The HLA-A, B, DR, DQ antigens of 7 kidney transplantations from living children donors were half-matched, including 2 cases higher than half-matched.Among 56 kidney transplantations from living sibling donors, 12 cases were totally mated, 34 cases were half-matched, and the rest were less than half-matched or mismatched. Among 72 kidney transplantations from other living relative donors, 20 cases were higher than half-matched and 5 cases were completely mismatched. More than 4 HLA antigens in 6 cases were matched, but not half-matched. Three HLA antigens or less were matched in 41 cases. Conclusion The HLA match rates from living parental, children, or sibling donors were higher than other relative donors.

Objective To explore the epidemic characteristics,clinical features and treatment outcome of brucellosis in the Dali area of Yunnan province.Methods The clinical data of 43 cases with brucellosis from Janurany 2012 to September 2015 were retrospectively analyzed.Results Among 43 cases,there were 35 males,8 females, 37 farmers,5 veterinary,and 1 teacher.42 patients had a clear history of contact with cattle and sheep,1 case of no clear history of exposure to cattle and sheep,mainly fever,accompanied by chills,headache,joint pain,low back pain, weight loss,hepatosplenomegaly etc.Laboratory routine examination showed no specificity,SAT was detected in 30 cases,positive rate was 100.0%,blood culture in 28 cases,23 cases were positive,the positive rate was 82.1%. 41 cases of adult patients with rifampicin and tetracycline or doxycycline + levofloxacin and cefotaxime drugs combined therapy,treatment for 6 weeks,2 cases of children took rifampicin and SMZ -TMP treatment for 6 weeks, improvement rate was 100%,there was no recurrence and death cases.Conclusion Dali area is popular in brucellosis, the clinical manifestations and the infection way diversification,need the attention of the clinicians.

Objective To compare the efficacy and safety of two intense pulsed light (IPL) devices for the treatment of facial photoaging.Methods A randomized split-face clinical trial was conducted,and 30 female subjects with facial photoaging were enrolled and randomized to receive treatment with Lumenis One on one half of the face and BBL on the other facial side,once every 3-5 weeks for 5 sessions.Each subject was followed up before the first treatment (the first interview),4 weeks after the third treatment (the second interview),4 weeks after the fifth treatment (the third interview) and 8 weeks after the fifth treatment (the fourth interview).During each follow-up period,global scores for photoaging (GSP) were used to evaluate the photoaging degree on the whole face,a 4-level grading method was applied to evaluate the improvement degree of 5 photoaging signs on each facial side,including wrinkles,skin texture,pigmented spots,telangiectasia and skin tightening,and the visual analogue scale (VAS) to assess pain induced by treatment.After the last treatment,self-assessment on the degree of satisfaction with therapeutic effects was conducted in subjects.Comparisons in the GSP and improvement scores between the two facial sides were conducted by repeated measures analysis of variance (ANOVA).Results A total of 26 subjects completed all the treatments and follow-up.Evaluation of the whole face showed that the GSP significantly decreased from 3.19 ± 0.75 before the first treatment to 2.15 ± 0.83 at 4 weeks after the third treatment (P ＜ 0.01).At 4 and 8 weeks after the fifth treatment,the GSP decreased to 1.85 ± 0.88 and 1.85 ± 0.97 respectively,and no significant difference was observed between the two GSPs (P ＞ 0.01).Evaluation of each facial side showed that improvement scores of skin texture,pigmented spots,telangiectasia and skin tightening on the two facial sides all increased at first and then decreased over the treatment time (Ftime =18.75,10.25,12.83,15.73,respectively,all P ＜ 0.05),and the improvement scores significantly increased at 4 weeks after the fifth treatment compared with those at 4 weeks after the third treatment (all P ＜ 0.017).There were no significant differences in the improvement scores of skin texture,telangiectasia and skin tightening between the third and the fourth interview,but the improvement score of pigmented spots decreased slightly at 8 weeks after the fifth treatment compared with that at 4 weeks after the fifth treatment (P ＜ 0.017).During the whole treatment period,no evident improvement was observed in wrinkles (Ftime =3.17,P ＞ 0.05),and improvement scores of 5 photoaging signs did not differ between the Lumenis One-treated side and BBL-treated side (all P ＞ 0.05).In addition,the VAS pain score was significantly lower in the BBL-treated side than that in the Lumenis One-treated side (4.62 ± 1.54 vs.5.80 ± 1.74,t =2.87,P ＜ 0.05).Most subjects were satisfied with the therapeutic effects (88.46％,23/26).Conclusion Both Lumenis One and BBL can be applied to treat facial photoaging safely and effectively,and improve signs of photoaging such as pigmented spots and skin texture,but the degree of pain on the BBL-treated side is milder than that on the Lumenis One-treated side.

Objective To evaluate the short and long term efficacy of self-expandable metallic stent implantation through bronchoscope in the management of the patients with malignant airway stenosis.Methods Seventy-four hospitalized patients with malignant airway stenosis during a 10-year period were selected as our subjects from Dec.2002 to Nov.2012 in the Respiratory Department of the Central Hospital of Wuhan.All these patients underwent bronchoscope for nitinol self-expandable metallic stent implantation.Clinical improvement,6min walking distance (6MWT),mMRC index,arterial blood gas,as well as early and late postoperative complications were investigated.Results A total of 77 stents were implanted,including 34 covered metallic stents and 43 uncovered metallic stents.All patients showed the obvious relief of dyspnea after the operation.6MWT at pre-operation was (172 ± 45)m and (288 ± 36)m at 28 week post-operation.Arterial blood gas was (61.34 ±6.44)mmHg at pre-opemtion and (72.12 ±6.87) mmHg at 28 week post-operation.mMRC was 3.56 ± 0.44 at pre-operation and 1.96 ± 0.37 at 28 week post-operation.All these differences were significant(P ＜ 0.01).The operation succeeded in releasing bucking of patients with esophago-tracheal fistula.Symptoms such as fever,cough,pharyngodynia,foreign body sensation and hemoptysis were observed,and all the above side effect could be solved while no serious complications arose.Conclusion Bronchoscopic insertion of metallic airway stents for malignant airway stenosis is a safe and effective procedure that could obviously relieve respiratory distress and improve the quality of life.