Objective To explore the relationship of post-transplant major histocompatibility complex class I chain-related gene A(MICA)antibody status and renal allograft function in clinical stable phase.Methods Fifty-seven patients accepted renal allografts followed up for at least 6 months were detected with the levels and specialties of MICA antibodies by Flow PRATM beads.Simultaneously,their serum ereatinine levels were tested as well.The impact of MICA antibody status on renal allograft function was assessed.Results Among the 57 patients,38 cases showed no HLA and MICA antibody.11 cases had HLA antibodies but not MICA antibody,8 cases had MICA antibodies and 3 cases had both MICA and HLA antibodies.There were 5 patients with MICA019 antibodies.3 patients with MICA027 antibodies,2 patients with MICA018 antibodies,while 1 patient with MICA004 and MICA017 antibodies,respectively.There were 9 patients with antibody positive score higher than 6,accounting 75%(9/12).Except age,there was no significant difference between patients with positive and negative MICA antibodies in the aspects of blood transfusion history,CDC,and cold ischemia time(P＞0.05).The average ages were(32.5±7.9)years for MICA antibodypositive patients and were(43.0±1 0.4)years for MICA antibody-negative patients(P=0.008).MICA antibody-positive patients without HLA antibody had higher serum creatinine level[(117.20±12.30)μmol/L]than MICA and HLA antibody-negative patients[(89.40±28.95)μmol/L,P＜0.05].Conclusions The measurement of MICA antibodies has prognostic value in the assessment of patients without HLA antibodies after renal transplantation.MICA antibody positive has clear association with chronic renal allograft function decline.

Objective To study the influence of human leucocyte antigen(HLA) and major his-tocompatibility complex class Ⅰ chain-related gene A (MICA) specific antibodies on renal allograft function and graft rejective reaction by monitoring their changes from preoperative to postoperative pe-riods. Methods Twenty-seven patients with renal aliografts were tested with the specificity of anti-HLA antibodies (anti-HLA class Ⅰ and anti-HLA class Ⅱ) and anti-MICA antibodies and their posi-tive value changes by flow PRATM beads. The HLA genotype was integrated to distinguish donor specific antibody(DSA) and non-donor specific antibody(NDSA). Their serum creatinine levels and clinical data were analyzed simultaneously. Results Of the 27 patients, 22 cases accepted renal transplantation from dead bodies and 5 eases accepted from live donors. Except 1 failed patient, the other 26 patients had good functional renal allografts. Twenty-four survival patients were followed up on month 1, 3, 6 and 12 after transplantation. Seven out of 27 patients had pre-exist antibody before transplantation. Among them, 2 patients had anti-HLA antibody; 3 patients had anti-MICA antibody; 2 patients had both anti-HLA and anti-MICA antibody. Three patients with no anti-HLA and anti-MICA antibodies before transplantation created antibodies after transplantation from 3 to 6 months. One patient created NDSA after transplantation and appeared chronic rejection. There were 3 patients who had anti-MICA antibodies before transplantation. The expression levels of antibodies had changed from high to low, but the specific anti-MICA antibody had not changed during the follow-up on month 1, 3, 6 and 12 after transplantation. The patient with pre-transplantation low level of anti-HLA class Ⅱ antibody appeared acute rejection with fever and his CMV was positive as well. The patient's SCr levels changed from 171 μmol/L to 236 μmol/L after I to 3 months post-transplantation. Twenty-four patients were divided into positive and negative groups according to the specific antibody. There was significant difference of SCr levels between the 2 groups 1 month and 1 year after transplantation(P= 0.03, 0.05). Conclusions It is important to detect the specificity and positive value of anti-HLA antibodies and anti-MICA antibody regularly during the post transplantation follow-up. This will make an effective therapy for decreasing the occurrenee and development of acute or chronic rejection and hy-pofunction on renal allograft.

Objective To explore the application value of monoexponential, biexponential models multiple b values diffusion weighted imaging(DWI) in distinguishing pancreatic cancer from non-tumorous pancreas.Methods Subjects comprised 37 pancreatic cancers confirmed by clinical or surgery.Pancreas multiple b values DWI was performed using 3.0T scanner.Standard apparent diffusion coefficient (ADCstandard) was calculated using monoexponential diffusion model.Pure diffusion coefficient (ADCslow), pseudodiffusion coefficient (ADCfast) and perfusion fraction (f) were calculated using intravoxel incoherent motion(IVIM) diffusion model.Parameters of pancreatic cancers and non-tumorous pancreas were compared using independent samples t test.Results Mean ADCslow value of pancreatic cancer was higher than that of non-tumorous pancreas (0.611×10-3 mm2/s vs 0.521×10-3 mm2/s,P=0.037).Mean ADCfast and f values of pancreatic cancer were lower than that of non-tumorous pancreas (5.066×10-3 mm2/s vs 7.188×10-3 mm2/s,P=0.035;55.8% vs 64.0%,P=0.016;respectively).ADCslow of pancreatic cancer was positively correlated to ADCstandard (r=0.824,P=0.000).ADCfast of pancreatic cancer was negatively correlated to f(r=-0.558,P=0.000).Conclusion ADCslow, ADCfast and f derived from IVIM-DWI model can distinguish pancreatic cancer from non-tumorous pancreas.IVIM-DWI may be a promising and non-invasive tool for early diagnosing and differentiating pancreatic carcinoma from non-tumorous pancreas.

Objective To explore the significance of designing with monitoring-flap in massive com- pound bone grafts for repairing massive bone defects in extremities.Methods From January 2001 to De- cember 2004,large bone defects in 19 patients(11 men and 8 women,age:6 to 35 years,mean age:18.6 years)were repaired by vascularized free fibular transplant with a monitoring-flap combining with massive deep frozen bone allografts.Average length of the bone defects was 16.6 cm(range,12 to 25 cm).A 7 days' con- tinuously clinical examination including observing the color,turgor,temperature,capillary refill,and bleeding after a needle sticking of the monitoring-falps were used postoperatively,if any one of these were abnormal,the circulation of the compound bone grafts must be in danger and some measures such as re-operation should be taken immediately.Dynamic image analysis was used for evaluating the bone union.Results One monito- ring-flap was vascular artieulo,and the articulo was relieved after exploration and resection of vein thrombus; another one was marginal part necrosis;the remains were normal.All of monitoring-flaps healed normally after 23.2 months(range,6 to 54 months)follow-up.15 patients had the radiographic evidence of bone unions 3 months after surgery.11 patients had been removed intermal fixation,complete bone unios were found one year postoperatively.Conclusion Designing with monitoring-flap in massive compound bone grafts for repairing massive bone defects,and can clearly understand the circulatory statue of compound bone grafts and early pre- dict the final results of massive bone allografts.

OBJECTIVESTo investigate the safety and feasibility of endoscopy in treating urinary tract calculi in preschool children.

METHODSFrom August 2004 to August 2008, 28 preschool children with urinary tract calculi were treated by endoscopy, 11 cases received ureterolithotripsy (URL) and 17 cases received minimally invasive percutaneous nephrolithotomy (MPCNL).

RESULTSOf 11 cases with ureteric calculi, 5 cases were rendered stone free in the first session, the other 6 cases received passive dilation by indwelling of ureteric stents for 1 to 3 weeks and underwent successful ureteroscopy with a 8/9.8 Fr rigid ureteroscope. Seventeen cases with renal calculi received MPCNL and were rendered stone free.

CONCLUSIONOur study shows that endoscopy in treating urinary tract calculi is safe and feasible in preschool children.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Nephrostomy, Percutaneous ; Treatment Outcome ; Ureteroscopy ; Urinary Calculi ; surgery

OBJECTIVETo investigate the biomechanical changes with different directions distraction at midface.

METHODSAn anteriorly directed 500 g force was applied to the floor of apertura piriforms in different directions to the occlusal plane. Three-dimensional finite element analysis was used to evaluate the biomechanical change of craniofacial complex.

RESULTSAs the force direction was moved downward, the sagittal distraction length of the craniofacial complex decreased and vertical movement changed from upward to downward. The craniofacial complex was moved anteriorly when the downward force was applied about 20-30 degrees to the occlusal plane. The forces could generate the uniform stress distribution in the craniofacial sutures and avoid counterclockwise rotation of the maxilla.

CONCLUSIONSThe craniofacial complex can be effectively distracted anteriorly when the downward force is applied to the floor of aperture piriforms in direction of 20-30 degrees to the occlusal plane.

Biomechanical Phenomena ; Computer-Aided Design ; Cranial Sutures ; Finite Element Analysis ; Humans ; Mandible ; physiology ; surgery

OBJECTIVETo investigate the value of serum cystatin C (Cys-C), urinary Cys-C, urinary retinol binding protein (RBP) and urinary neutrophil gelatinase-associated lipocalin (NGAL) in the early assessment of multiple myeloma (MM) and their characteristic changes in different pathological types of renal impairment.

METHODSAccording to glomerular filtration rate (eGFR), the patients were divided into two groups, of which marked group A with normal renal function, the other marked group B with abnormal renal function. Sixty healthy subjects were chosen as control. Detection of the serum Cys-C, urinary RBP, urinary Cys-C, urinary NGAL, serum creatinine (Scr), urinary microalbumin (MAU) and urinary α1-microglobulin (α1-MG) were performed. Renal biopsy was carried out for patients who had abnormal serum Cys-C, urinary Cys-C, urinary RBP, urinary NGAL and were willing to accept further test.

RESULTSCompared with healthy controls, the serum Cys-C, urinary RBP, urinary Cys-C, urinary NGAL of group A were significantly higher than that of healthy controls. Six group A patients received renal biopsy, and varying degrees of renal damage were discovered. The serum Cys-C, urinary RBP, urinary Cys-C and urinary NGAL positive rate were 66.7%, 66.7%, 66.7% and 83.3%, respectively. Of twenty-four cases received biopsy after abnormal examination results were shown, six turned out to be amyloidosis, twelve cast nephropathy (CN) and 6 monoclonal immunoglobulin deposition disease (MIDD). Compared with MIDD and amyloidosis, the urinary Cys-C and NGAL of the CN group are significantly higher (P < 0.05). Compared with CN and amyloidosis, urinary RBP of MIDD is significantly higher (P = 0.043). Compared with MIDD and CN, the MAU of amyloidosis is significantly higher (P = 0.006).

CONCLUSIONCompared with the conventional indicators, serum Cys-C, urinary Cys-C, RBP and NGAL are more sensitive in early assessment of MM patients with renal damage. The MAU is higher in amyloid, the urinary Cys-C and urinary NGAL are significantly elevated in CN, the urinary RBP is significantly elevated in MIDD.

Acute-Phase Proteins ; urine ; Adult ; Aged ; Case-Control Studies ; Cystatin C ; blood ; urine ; Female ; Humans ; Kidney ; pathology ; Kidney Diseases ; blood ; diagnosis ; urine ; Kidney Function Tests ; Lipocalin-2 ; Lipocalins ; urine ; Male ; Middle Aged ; Multiple Myeloma ; blood ; pathology ; urine ; Proto-Oncogene Proteins ; urine ; Retinol-Binding Proteins ; urine

OBJECTIVEThe purpose of this study was to investigate the biomechanical changes of midface skeleton protraction at its medium position in the craniofacial complex, using the three-dimensional finite element method (FEM).

METHODSA three-dimensional FEM model was developed from the CT scan images by the technologies of three-dimensional reconstruction, image processing and meshing. The protraction forces were applied to the following locations: the first molar, full maxillary arch, and the floor of aperture piriforms. Biomechanical changes from different position protraction were investigated by means of finite element analyses.

RESULTSProtraction forces at the level of the floor of aperture piriforms produced a more forward movement of the upper maxilla in sagittal direction. Vertical and lateral displacements were less than those in loading with teeth or denture. Compressive stress on the radix nasi decreased obviously in midface skeleton protraction at its medium position.

CONCLUSIONSCompared with traditional orthopedic protraction, midface skeleton protraction at its medium position could advance maxilla en bloc, decrease the counterclockwise rotation of the maxilla, and reduce the constriction of the anterior part of the palate.

Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Maxilla ; surgery ; Skull ; surgery ; Stress, Mechanical

To explore anti-tumor active components of Chimonanthus salicifolius, the phytochemistry of the chloroform fraction from leaves extract was investigated by repeated silica gel column chromatography. Twelve compounds were isolated and their structures were identified by physicochemical properties and spectroscopic data analysis as 9-epi-blumenol C(1), blumenol C(2), (+)-dehydrovomifoliol (3), (+)-vomifoliol (4), robinlin (5), (-)-loliolide (6), isofraxidin (7), scopoletin (8), 6,7-dimethoxycoumarin (9), 6, 7, 8-trimethoxycoumarin (10), beta-sitostenone (11), and beta-stigmasterol(12). Compounds 1-6 belonging to nor-sesquiterpenoids were isolated from the family Calycanthaceae for the first time. Compound 1 was a new natural product. Compounds 7, 11 and 12 were obtained from this plant for the first time.
Antineoplastic Agents ; analysis ; isolation & purification ; Calycanthaceae ; chemistry ; Chloroform ; chemistry ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Plant Leaves ; chemistry

OBJECTIVEThe purpose of this study was to explore suppositional sutural construction and protraction in the three-dimensional finite element model of craniofacial complex.

METHODSCombining spiral CT scanning technology with the three-dimensional finite element method, three-dimensional FEM model of craniofacial complex was developed for analysis. In the model, craniofacial sutures were constructed through the MSC. Patran program and different mechanical properties of sutures were applied. Under the same loading condition, bone displacements of the maxilla were calculated.

RESULTSA three-dimensional FE model of craniofacial complex, comprising teeth and craniofacial sutures, was developed. The displacement of the skeletal structures with sutures was significantly larger than that without sutures.

CONCLUSIONSThe construction of craniofacial sutures in the three-dimensional finite element model of craniofacial complex could improve the accuracy of finite element model, which set up good foundation for biomechanical studies of craniofacial complex.

Cephalometry ; methods ; Child ; Cranial Sutures ; anatomy & histology ; diagnostic imaging ; Female ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Materials Testing ; Radiography