0.05). In group B,the serum creatinine levels of cases treated with ulinastatin at 1,3,7,10 and 14 days after renal transplantation were (372.6? 128.1 ),(278.4?38.9),(145.9? 47.2 ),(133.2?39.8),(128.0?30.6)?mol/L,respectively;the values of controls were (496.3?125.6),(364.7?60.2),(196.2?36.8),(161.4?41.5),(149.8? 33.5 )?mol/L,respectively ( P

Objective To summarize the modified clinical technique and experience of simultaneous kidney-pancreatic transplantation (SKPT) with enteric drainage(ED). Methods Two patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with enteric drainage of exocrine secretions.The patients were treated with quadruple therapy including antithymocyte globulin (ATG) induction therapy,prednisone,FK506,and Mycophenolate-Mofetil(MMF), as maintenance immunosuppression. Results The two patients became insulin-independent after treated by small dose insulin for 5～10 days and Scr,BUN became normal 3～5 days after the operation.Until now all the grafts of the patients functioned well. Conclusions ED-SKPT is more effective than simultaneous kidney-pancreatic transplantation with bladder drainage (BD-SKPT).ED-SKPT is an effective method for treating type Ⅰdiabetes mellitus with uremia.Finer allograft and nicer HLA-typing can decrease complications.

Objective To study the diagnosis and management of renal artery stenosis in kidney transplants. Methods 8 cases of transplant renal artery stenosis (TRAS) were reviewed and studied . Results Color-flow Doppler has been helpful in the diagnoses for 5 of the 8 cases with a specificity of 78% and a positive predictive value of 62.5%. 7 patients underwent PTRA and have been cured of the renal stenosis in a short term. On follow up for 3～12 months, the creatinine was 186.2～121.3 ?mol/L; 1 patient underwent nephrectomy. Conclusions TRAS should be considered when ever there is hypertension of unknown cause, a sudden reduce of urine volume and on increase of creatinine after kidney transplantation. Color-flow Doppler is indicated for the screening of TRAS whereas PTRA is the procedure of first choice for the management.

Objective To explore the preliminary experience of combined liver-kidney transplantation.Methods Twelve patients were subjected to combined liver-kidney transplantation. The orthotopic liver transplantation was preceded with the classic fashion in 8 patients and the piggyback fashion in 4 patients. The pump-driven veuovenoas bypass technique was not used. And then the kidney transplantation was performed under stable homodynamic circumstance. The renal graft was implanted to the right iliac fossa routinely. The renal vein was anastomosed to the external iliac rein end-to-side, and the renal artery to the external iliac artery end-to-side or the hypogastric artery end-to-end. After operation, anti-CD25 monoclonal antibody or antithymocyte globulin (ATG), tacrolimus (FK506), mycophenolate mofetil and prednisone were used to prevent the allograft rejection.Results The survival rate of the 12 cases receiving combined liver-kidney transplantation was 100 %, and the graft function was restored well postoperation. An acute rejection episode of liver occurred in one patient. The FK506 toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pneumonia occurred in one case and the peritoneal infection in one patient. No patient experienced any episode of acute rejection of renal allograft.Conclusions The combined liver-kidney transplantation is the ideal option of patients with end-stage liver disease with chronic renal failure.

Objective To investigate fluoride-induced inflammation and nuclear factor-κB (NF-κB) signaling pathway in cultured human acute monocytic leukemia cells (THP-1).Methods In vitro cultured THP-1 cells were used as a model of microglia.After cultured with different concentrations of [0 (negative control group),10,50,100,500,1 000 and 5 000 μmol/L] sodium fluoride (NaF) for 48 h,the survival of cells was detected by CCK8.THP-1 cells were divided into 3 groups:control group,low dose and high dose fluoride groups according to the results of CCK8 assay,and then treated with different concentrations of sodium fluoride (0,500,5 000 μmol/L) for 48 h,concentrations of inflammatory cytokines,such as Interleukin-lβ (IL-1β) and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) in THP-1 mononuclear cell culture medium.The protein levels of IκBα,phospho-NF-κB p65 and phospho-IκB-α were detected by Western blotting.Results THP-1 cells were treated with different concentrations of sodium fluoride (500,1 000,5 000 μ mol/L) for 48 h.Fluoride group THP-1 cell survival rate [(73.21 ± 3.67)％,(31.40 ± 4.56)％,(0.40 ± 0.24)％] was lower than that of the negative control group [(100.00 ± 0.00)％,all P ＜ 0.01].Compared to the control groups [(0.36 ± 0.07),(31.07 ± 0.81)ng/L],significant increases of the inflammatory cytokines IL-1β [(1.42 ± 0.79),(19.47 ± 2.90)ng/L] and TNF-α [(61.06 ± 2.20),(172.72 ± 2.29)ng/L] were detected in culture medium in low-fluoride and high fluoride groups,respectively.Interestingly,compared to the control groups [(100.00 ± 5.48)％,(100.00 ± 14.82)％],significant increases of phospho-NF-κB p65 [(113.71 ± 8.99)％,(134.74 ± 1.93)％] and phospho-IκB-α [(152.61 ± 14.16)％,(176.91 ± 7.95)％] were observed in both low-fluoride and high fluoride groups.Meanwhile,the protein level of IκBα in high fluoride group [(63.53 ± 9.67)％] was significantly lower than that of the control group [(100.00 ± 10.99)％,P ＜ 0.01].Furthermore,significant positive correlation was detected between increased IL-1β,TNF-α and phospho-NF-κB p65 (r =0.74,0.72,all P ＜ 0.05).Conclusions Excessive fluoride can induce microglial cells to release inflammatory cytokines and activate nuclear factor-κB signaling pathway.The release of inflammatory cytokines and activation of the signaling pathway may be one of the mechanisms of the damage of the central nervous system caused by sodium fluoride.

Objective To investigate the pathological role of endoplasmic reticulum stress in fluomsisinduced apoptosis in human hepatocellular carcinoma cell line (HepG2).Methods Under stimulation of 1,3,6,9 mmol/L concentrations of NaF in vitro for 24 h,while normal control group was cultured under normal condition,the apoptosis of HepG2 cells was measured by flow cytometry.The endoplasmic reticulum stress markers (glucose regulative proteins 78,94;GRP78,GRP94) and CCAAT/enhancer-binding protein homologous protein (CHOP) in HepG2 cells were measured at both mRNA and protein levels by real-time PCR and Western blotting,respectively.Results After treated with 0,1,3,6,9 mmol/L NaF for 24 h,the apoptosis rate of HepG2 cells was (6.25 ± 1.27)％,(13.48 ± 1.00)％,(24.08 ± 1.88)％,(30.19 ± 3.07)％ and (37.72 ± 4.43)％,respectively,and the difference was statistically significant among groups (F =65.828,P ＜ 0.01).After treated with 3 mmol/L NaF for 24 h,the mRNA level of GRP78,GRP94 and CHOP was (1 172.41 ± 459.60)％,(946.95 ± 635.85)％ and (7 846.97 ± 1 670.01)％,which was increased compared to those of the control groups [(100.00 ± 1.77)％,(100.00 ± 2.08)％,(100.00 ± 0.74)％,t =12.77,4.67,11.50,all P ＜ 0.01].Under the same condition,the protein levels of GRP78 and CHOP were (159.99 ± 67.59)％ and (155.15 ± 94.24)％,which were increased compared to those of the control groups [(100.00 ± 30.68)％,(100.00 ± 41.44)％,t =-3.27,-1.99,all P ＜ 0.05],while GRP94 protein level [(46.40 ± 41.46)％] was decreased compared to that of the control group [(100.00 ± 68.86)％,t =4.02,P ＜ 0.05].Conclusion Endoplasmic reticulum stress may be involved in NaF-induced cell death in HepG2 cells.

Objective To study the In vitro expansion of human CD8+ CD28- suppressor T cells and their immunological regulatory effect.Methods Human CD8 + CD28- suppressor T cells were expanded in vitro driven by the combination of cytokines and allogeneic antigen presenting cells (APCs).Flow cytometry was used to assess the development of CD28- subpopulation.Expanded CD8+ CD28- T cells were isolated by immunomagnetic microspheres and then added as third part modulators into mixed lymphocyte culture to assess their immunological regulatory characteristics.Results The combination of cytokines included IL-2,IL-7 and IL-15 and allogeneic APCs could increase the portion of CD8 + CD28- T cell subtype,and expansion fold of CD8+ CD28- T cell subtype was significantly increased as compared with others (P＜0.05).Expanded CD8+ CD28- T cells could suppress the proliferation of CD4+ T cells stimulated by allogeneic APCs.Moreover,this suppression had antigen specificity.Conclusion Human CD8 + CD28- suppressor T cells can be in vitro expanded in large amounts driven by the combination of cytokines and allogeneic APCs.Expanded CD8 + CD28- T cells in this study have antigen specific regulatory characteristics.

A retrospective analysis was carried out in 36 patients with blunt diaphragmatic rupture during March 1991 and March 2006. Twenty-two diagnoses were confirmed preoperatively, and the rest 14were confirmed perioperatively. Three patients underwent surgical treatment after no response to conservative therapy. Thoracotomy was performed in 21 patients, laparotomy in 9, thoracotomy plus laparotomy in 5 and combined thoraco-laparotomy in 1. Most diaphragmatic rupture may be caused by blunt collision and could lead to thoracoabdominal injury. In spite of high mortality rate, the condition is usually under diagnosed. Definite diagnosis and timely operation are important to increase survival rate and reduce mortality.

Objective To evaluate whether serum cystatin C (SCys C) could be used as an ideal index to assess renal function of renal transplant recipients during posttransplant follow-up.Methods Seventy patients who were followed up for at least 6 months after renal transplantation in our centre were recruited in the study. SCys C and serum creatinine (SCr) were determined during the follow-up period, and glomerular filtration rate (GFR) was measured using an isotope Tc99m DTPA.The correlation between SCys C, SCr and GFR was analyzed. The performance of SCys C and SCr in diagnosing the mild impairment of renal allgraft function (GFR ＜ 1 ml/s) was evaluated using ROC curve. Results Both SCys C and SCr had a linear negative correlation with GFR (r = -0. 82 and -0. 66 respectively, P＜0. 01 ). The sensitivity, specificity and positive predictive values (PPV) of SCys C for diagnosing the mild impairment of renal allgraft function were higher than those of SCr,but the AUC of SCys C did not differ from that of SCr significantly (0. 935 vs. 0. 877, P＞0. 05).Conclusion SCys C could be used an ideal index to evaluate the allograft renal function for its better correlation with actual GFR.

Objective To investigate the possible mechanism of endonuclease G (Endo G)-mediated non-Caspase-dependent apoptotic pathway in brain neuronal apoptosis in chronic fluorosis rats.Methods Sixty Sprague Dawley (SD) rats (half male and half female) were randomly divided into two groups:control group fed with tap water with fluoride content ＜ 0.5 mg/L and fluorine group in which sodium fluoride was added into drinking water with fluoride content of 50.0 mg/L.Both groups were fed with standard food with fluorine content ＜ 0.5 mg/kg.The experiment period was 10 months.At the end of the experiment,all the animals were sacrificed,and brain tissue was taken.Flow cytometry was used to examine apoptosis rate,immune-histochemistry was employed to detect the distribution of Endo G in brain tissue;Western blotting was used to test the protein expression of Endo G.Results Compared to the apoptosis rate of control group [(1.3 ± 0.6)％,(1.9 ± 0.3)％],the apoptosis rate in hippocampus and cortex of rats with chronic fluorosis [(2.6 ± 0.6)％,(3.1-± 0.7)％] was significantly increased (t =3.1,3.4,all P ＜ 0.05).The Endo G positive neurons and their degree of staining in CA1,CA2,CA3 and CA4 of hippocampus,frontal cortex as well as the upper layer of parietal cortex [(11.1 ± 2.2),(10.2 ± 1.9),(9.8 ± 3.1),(9.9 ± 1.6),(10.6 ± 2.9),(8.2 ± 2.4),(11.1 ± 2.8) scores] in rats with chronic fluorosis were significantly higher than those in the control group [(5.8 ± 1.8),(6.7 ± 2.6),(5.2 ± 2.4),(7.2 ± 2.1),(7.7 ± 2.6),(6.1 ± 1.9),(8.1 ± 2.6) scores,t =2.9,2.5,2.4,2.3,2.2,2.5,2.3,P ＜ 0.01 or ＜ 0.05].The protein level of Endo G in the mitochondria of rat brains with chronic fluorosis [(86.4 ± 7.2)％,(83.9 ± 6.8)％] was significantly lower than that of control group [(100.0 ± 6.1)％,(100.0 ± 5.5)％,t =2.6,2.3,all P ＜ 0.05].Meanwhile,the protein level of Endo G in the nucleus of neurons from chronic fluorosis rats [(117.5 ± 6.4)％,(115.2 ± 6.2)％] was significantly higher than that of the control [(100.0 ± 5.2)％,(100.0 ± 5.5)％,t =2.5,2.2,all P ＜ 0.05].Conclusion The high expression of Endo G and nuclear transfer are related to the neuron apoptosis in chronic fluorosis rat,which may be one of the mechanisms of brain injury of the disease.