Graft vs Host Disease ; drug therapy ; Humans ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; therapeutic use

With the development of organ transplantation for nearly half a century, currently the hot issues in clinical renal transplantation have already shifted to the application of low toxicity immunosuppressive drugs and their projects, as well as the research of technique which induces low or no immunity response to the specific donor. At present the main effective strategies of inducing immune tolerance are donor specific blood transfusion and donor specific bone marrow transplantation. This article summarizes the background, mechanism and clinical application of these two strategies.

Objective　To explore the effect of hypoxia on the apoptosis of cultured human umbilical vein endothelial cells（HUVECs） and the role of vascular endothelial growth factor（VEGF） in inhibition of apoptosis． Methods　①Culture and identification of HUVECs．②Establishment of hypoxic model（0，12，24，48 h）in HUVECs．③Incubation of HUVECs with VEGF(0 ng, 100 ng) under hypoxic condition for 24 h. ④Detection of apoptosis of HUVECs with TUNEL method． Results　The percentages of apoptosis were different under different hypoxic conditions． The longer hypoxic time was，the higher apoptosis percentage was．VEGF reduced the apoptosis of HUVECs induced by hepoxia． Conclusion　Over-apoptosis EVCs in one of the important factors for the impairment of endothelial function. HEGF inhibits the apoptosis of HVCs and having a pretive function on them.

Objective To explore the efficacy and safety of Polyethylene glycol 3350 plus electrolyte bulk on the schizophrenia patients with constipation induced by clozapine. Methods 150 cases of schizophrenia inpatient and outpatient with constipation induced by clozapine treatment were selected and randoly dirided into the group of polyethylene glycol,lactulose group and non-intervention group with 50 patients in each group and each patient or their families signed the informed consent. The treatment groups took orally with Polyethyle ne glycol 3350 plus electrolyte 13. 7grams,2 times per day and lactulose oral solution 10ml,3 times per day respectively. The non-intervention group was not given a regular basis laxatives, but with cathartic therapy in demand. The period of experiment was 6 weeks including 2 weeks baseline observation period and 4 weeks treatment. Assessment criteria: an overall assessment of all symptoms of patients and each patient's constipation and safety parameters were assessed. Results After treatment for 4 weeks,the total effective rate in three groups was 90.0% ,68.0% ,38.0% (all P ＜0.05). The difference was statistically significant. The normal shape of stool rate was 84.0% ,60.0% ,28.0%. PEG group were better than the other 2 groups at baseline in the first defecation time,the average times of bowel movements per week,theutilization of laxatives during treatment, while symptom score improvement in the stool was significantly better than other groups after treatment. The safety parameters including liver and kidney function, lectrolytes, glucose, ECG, symptoms of schizophrenia such as PANSS score had no obvious change in each group after treatment. Conclusion PEG 3350 plus electrolytes was effective and safe in the treatment of clozapine-indueed constipation in chronic schizophrenia.

AIM:To determine the relationship between ischemia,hypoxia and the production of vascular endothelial growth factor in rat myocardium and its basic mechanism. METHODS:(1) 28 Wistar rats were randomly divided into 4 groups: group A,normal control;group B,1 day's acute myocardial infarction;group C,3 day's acute myocardial infarction;group D, 7 day's acute myocardial infarction. (2) Rat cardiac myocytes cultured were primarily divided into some groups, hypoxia incubated 24 hours; PMA groups, hypoxia incubated 24 hours with PKC activator (PMA), A 0 ng/mL; B 10 ng/mL; C 100 ng/mL; D 1 000 ng/mL; Chelerythrine groups, hypoxia incubated 24 hours with PKC inhibitor (chelerythrine), A 0 nmol/L; B 10 nmol/L. (3) By computer scanned and quantitated, vascular endothelial growth factor (VEGF) protein was detected with immunohistochemical technique. RESULTS: The longer time of ischemia and hypoxia was, the higher the VEGF production. The relationship was found between the time of ischemia or hypoxia and the production of VEGF. The production of VEGF protein was further promoted by PMA with different concentration, decreased by chelerythrine.CONCLUSION:Ischemia or hypoxia strongly stimulated the production of VEGF in myocardium, which played an important role in autoprotecting of ischemic or hypoxic myocardium. Hypoxia-induced PKC activation is one kind of basic mechanisms in this course.

The exoerythrocytic forms (EEF) of Plasmodium yoelii yoelii BY265 in the liver of rats and mice are morphologically similar, however, the size of the matured EEF in the former is far much larger than that in the latter. In the sections of the liver of both the animals, which are sliced 48-65 hours after the inoculation of sporozoites, certain degenerated EEF can be found. The degenerated EEF fall into two types:(1) Degenerated EEF without WBC infiltration, These EEF usually remain intact in their outline with many vacuoles of the size 1-6?m in diameter in the cytoplasm. The nuclei of the host hepatic cells parasitized are usually swollen and appear blank after staining. No WBC infiltration can be found.(2) Degenerated EEF with WBC infiltration: The outline of these degenerated EEF is no more intact. They are usually infiltrated and/or surrounded by WBC.Degeneration occurs in 6.6% of the EEF in rats and 5.8% in mice. Once the normally developed parasites become matured and ruptured, large amoants of WBC are attracted and accumlated to form local foci of WBC infiltration of the size 35-90?m in diameter. In some of the foci, remnants of the parasites can be seen, while in some others, no remnants can be found and they most likely are also formed by the degenerated EEF or ruptured matured parasites.

Objective To analyse the changes of a district general hospital before and after management by Shanghai Renji Medical Group through current situation survey,and explore the conditions for the development of district general hospitals.Methods The Zhujiajiao People's Hospital of Qingpu District in Shanghai was selected,and patients(n=50)and hospital staff(n=100) were conducted current situation survey with questionnaires which included the knowledge and evaluation of the hospital's current situation as well as the changes before and after management by Shanghai Renji Medical Group.Results Half year after management by Shanghai Renji Medical Group,great progress in medical work was achieved,with a favourable development trend.The rate of satisfaction on medical service evaluated by inpatients reached 89.60%,and 81.91% hospital staff had confidence in the sustainable development of the hospital. Conclusion Management by Shanghai Renji Medical Group has brought prospects for the Zhujiajiao People's Hospital.Under current environment,only certain conditions are met can a district general hospital achieve sustainable development.

AIM To explore the effect of hypoxia on apoptosis in human umbilical vein endothelial cells(HUVECs) and the role of ecdysterone(EDS)in inhibition of apoptosis. METHODS ① Culture and identification of HUVECs;② Hypoxic model(0,12,24,48 h) in HUVECs was established. While HUVECs was incubated 24 h with EDS(100 mg?L -1 ) under hypoxic condition. Apoptosis in HUVECs was detected by TUNEL;③ HUVECs received EDS 100 mg?L -1 in normal and hypoxic condition. After 24 h, vascular endothelial growth factor (VEGF) was detected with immunohistochemical technique. RESULTS The apoptosis percentages are different under different hypoxic condition. The longer hypotic the time was, the higher the apoptosis percentage was. EDS reduced apoptosis of HUVECs. EDS could enhance expression of VEGF protein in cardiac myocytes of rat in normal and hypoxic condition. CONCLUSION The role of hypoxia in HUVECs apoptosis is more significant along with prolonging of hypoxic time. VEGF play an important role in protective effect of EDS on endothelial cell apoptosis.

Objective To compare the biomechanical performance of three different fixation instruments for tibial fractures.Methods Fourteen fresh tibial specimens were made into models of oblique fracture.Seven models were fixed with unilateral axial dynamic fixation(UADF),and seven with limited contact dynamic compression plate(LC-DCP).After biomechanical tests had been done for the UADF group,an extra screw was used at the oblique fracture site to reinforce the fixation with extra limited internal fixation.Each model was tested for its hiomechanical performance in resisting compression,bending and rotation.Results The performance of UADF was significantly poorer than that of LC-DCP and UADF with limited internal fixation in anti-compression,an- ti-bending and anti-rotation(P＜0.05).There was no significant difference in the rigidity between LC-DCP and UADF with limited internal fixation(P＞0.05).Conclusion UADF with extra limited internal fixation is a recommendable method for tihial fractures because it cart provide the same effective fixation as LC-DCP does.

Objective To investigate effects of co-grafts of bone marrow stromal cells (BMSCs) combined with nerve growth factor (NGF) suspension on repair of spinal cord injury (SCI) in adult rats so as to determine whether the co-grafts are more effective than a single protocol.Methods Spinal cords of adult rats (n=32) were injured by the modified Allen's method.One week after injury,the injured cords were injected with Dubecco-modified Eagles Medium,BMSCs,NGF,and BMSCs plus NGF respectively.One month and two months after injury,rats were respectively sacrificed-and their injured cord tissues were sectioned to identify the transplanted cells under fluorescent microscopy.We observed axonal regeneration and differentiation of BMSCs through immunocytochemical staining conducted with neurofilament (NF) and Neuron-Specific Nuclear Protein (NeuN) and glial fibrillary acidic protein (GFAP).We measured the cavity volume by staining with hematoxylin-eosin (HE).At the same time,rats were subjected to behavioral tests using the open-field BBB (blood brain battier) scoring system.Results One month and two months after transplantation,immunocytochemical staining showed that transplanted cells partially expressed NeuN and GFAP.At the same time,significant reduction in lesion area (P＜0.05) and improvement in BBB lo- comotor rating scale (P＜0.05) were observed in the cases that received implantation,as compared with those that received vehicle injection.More importantly,further reduction in lesion area and improvement in function were ob- served in the combined treatment group.Conclusions BMSCs can differentiate into neurons and astroeytes. BMSCs and NGF can reduce lesion size,promote axonal regeneration and improve functional recovery,and may have a synergistic effect.