Objective To observe the curative effectiveness of kidney transplantation on uremic patients complicated with Thalassemia.Methods Forty-six cases of uremic patients complicated with Thalassemia(26 cases of alpha-thalassemia,20 cases of beta-thalassemia)subject to kidney transplan- tation were retrospectively studied as the anemia group.Incidence of delayed graft function restoration, rejection(hyperacute rejection,accelerated rejection and acute rejection)and anemia correction were observed.Time needed for renal function restoration was recorded and creatinine value(Cr)was mea- sured in those patients whose kidney function restored after kidney transplantation.Control group in- cluded 131 cases of kidney transplantation performed concurrently that accompanied with different con- tent of anemia other than thalassemia.Results Incidence of DGF was 26.1% and 23.7% in thalasse- mia group and control group,respectively.Six months after transplantation,39 cases in thalassemia group and 109 cases in control group with follow-up were host and kidney alive.In 6 months,rejection ratio was 30.8% in thalassemia group and 32.1% in control group respectively.Cr value was(121?20)?mol/L and(128?33)?mol/L in thalassemia group and control group,respectively.Ratio of anemia correction in thalassmia and control groups was 79.5% and 76.1%,respectively.No indexes above were found to be statically significantly different between these two groups.Conclusion Uremic patients complicated with thalassemia is suitable for kidney transplantation,with clinical effectiveness similar to those without thalassemia.

Objective To probe into the clinical features, ways of diagnosis and treatment measures of concurrent paratyphoid fever A after renal transplantation. Methods The 5 patients were all town or village people under the county level. After the operation, the immunosuppressive scheme of ciclosporin A (or Tacrolimus) + mycophenolate mofetil (MMF) + prednisone acetate was adopted. One case was caused by catching cold and the rest 4 had no any distinct inducement. Five patients fell ill respectively at the 5th, 7th, 7th, 9th and 14th month after the operation. On the admission, the 5 patients suffered from gastrointestinal symptoms such as vomiting and diarrhea to varying degrees; 3 from toxic symptoms such as fever, intolerance of cold, hypodynamia and headache; 3 from symptoms of the respiratory system such as stuffy nose and congestion of throat; 1 from elevation of blood pressure; 1 from relative slow pulse. In 3 patients with decrease of urine volume, 1 suffered from gross hematuria, swelling of transplanted area of the kidney, pain on pressure and rise of blood pressure. Only 1 patient's paratyphoid fever A antibody in the Widal's test gastroenteritis or untoward reaction of MMF and the curative effect was bad. After definite diagnoses,the combined treatment of the third-generation cephalosporin and FQNS were given to all of them.After treatment for 7-10 days, the symptoms in all patients all disappeared. During the treatment, 1 patient was diagnosed as acute rejection and given the methylprednisolone shock for 3 days. After that, the patient's graft function was improved; 3 patients suffered from relatively great fluctuation of blood concentration of immunosuppressive agent and toxic symptoms such as decrease of the graft function, etc. After adjustment of dosage, their indicators of renal function became normal. Conclusion Early symptoms and accessory examinations of paratyphoid fever A after renal transplantation lack specificities. Diagnosis of paratyphoid fever A after renal transplantation mainly depends on blood culture. Drugs of first choice include FQNS and the third-generation cephalosporin. During the treatment, the doctor should closely monitor blood concentration of the immunosuppressive agent.

The risk factors,especially laboratory indicators,of prognosis after acute kidney injury (AKI) remain unclear.We conducted a retrospective survey of Chinese People's Liberation Army General Hospital from January 1,2012 to December 31,2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes.The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis.Among 77 662 cases of hospitalized patients,1387 suffered from AKI.The incidence rate and mortality of AKI were 1.79％ and 14.56％,respectively.Multivariate logistic regression analysis revealed that high AKI stage,age greater than 80 years,neoplastic disease,low cardiac output,increased white blood cell count,and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients.Conversely,body mass index between 28 and 34.9 was a protective factor.Increased AKI stage,tumor disease,post-cardiopulmonary resuscitation,and RRT were the risk factors of renal function recovery upon discharge.In addition to traditional risk factors,white blood cell count,platelet count,albumin,and BMI were the predictors of the mortality of AKI patients.No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.

Objective To explore the application and nursing of propofol combined with tramadol on gastroscope detection in patients with hypertension.Methods One hundred and twenty cases with hypertension undergoing gastroscope detection were randomly divided into 2 groups.Sixty cases of study group were injected with propofol and tramadol while the other 60 cases of control group received routine method.HR, SBP, DBP, SPO2 and other indictors were recorded during gastroscope detection and the data were analyzed.Results HR, SBP, and DBP in study group were significantly lower than in control group (P <0.01) , but there were no difference in SpCO2 .Conclusions The combination of propofol and tramadol is safe and effective on gastroscope detection in hypertension patients.Intensive monitor and nursing are very important in the process of gastroscope detection.

Abstract: Objective　To analyze the survival status of HIV/AIDS patients aged above 50 years receiving antiviral therapy (ART) in Shanxi Province from 2011 to 2019, and to provide evidence for further improvement of antiviral therapy. Methods　Basic information and follow-up information of HIV/AIDS patients aged above 50 years who first received HIV/AIDS antiviral therapy in Shanxi Province from 2011 to 2019 were collected. Excel database was established and SPSS23.0 software was used for analysis. Retrospective cohort study was conducted. Cox proportional risk regression model was used to analyze the factors influencing survival time. Results　A total of 1 183 subjects were included, of which 172 died, including 84(48.84%) from other causes, 74(43.02%) AIDS-related death and 14 (8.14%) from accidents, suicides and undetermined deaths. Setting AIDS-related deaths as an outcome event, life table analysis showed that the cumulative survival rates at 1, 3, 5, 7 and 9 years after receiving ART were 96.61%, 93.59%, 90.35%, 87.57% and 83.44%, respectively. Multivariate Cox proportional risk model analysis showed that the risk of death in patients aged 60-<70 years group and over 70 age group was 2.53 times (95%CI: 1.51-4.23) and 3.59 times (95%CI: 1.74-7.40) for patients aged the 50-<60 group , respectively. The risk of death in patients with baseline CD4+T lymphocyte (CD4) counts of ≥200/mm3, 50-<200 /mm3 was 0.22 times (95%CI: 0.12-0.41) and 0.37 times (95%CI: 0.21-0.67) for patients with CD4+T lymphocyte counts of <50/mm3. The risk of death in patients with opportunistic infections at baseline was 1.99 times (95%CI: 1.16-3.39) for patients without baseline opportunistic infections. Conclusions　The survival rate of HIV/AIDS patients aged above 50 who received antiviral therapy (ART) in Shanxi Province from 2011 to 2019 was relatively high. To further improve the quality of antiviral treatment in our province, the strategy of "early detection and early treatment" should be continued and improved in the future, and information collection of specific causes of non-AIDS-related deaths among this population should be further strengthened.

Objective To investigate the expression of CD27-CD70 co-stimulatory pathway in peripheral circulation and intestinal mucosa of patients with inflammatory bowel disease, and to find the difference between the expression of CD27-CD70 in patients with inflammatory bowel disease and in healthy controls. Methods A total of 62 patients with Crohn's disease, 64 patients with ulcerative colitis and 56 healthy controls were enrolled. Enzyme-linked immunosorbent assay was applied to evaluate plasma CD27-CD70 protein expression in patients with inflammatory bowel disease and healthy controls. SYBR-green real time PCR was applied to access CD27-CD70 mRNA expression in peripheral blood mononuclear cells in patients with inflammatory bowel disease and healthy controls.And CD27-CD70 protein expression in intestinal mucosa was determined by immunohitochemistry.Results Plasma levels of CD27 (P=0. 025) and CD70 (P=0. 000) were significantly higher in patients with Crohn's disease than in healthy controls. However, CD27 (r= 0. 055, P= 0. 673) and CD70 (r= 0. 024, P = 0. 852) were not significantly associated with endoscopic disease activity in patients with Crohn's disease. Similarly, CD27 (P=0. 001) and CD70 (P=0. 000) were significantly higher in patients with ulcerative colitis than in healthy controls. And CD27 (r=0. 077, P=0. 547)and CDT0 (r=0.021, P=0. 869) were not significantly associated with endoscopic disease activity in patients with ulcerative colitis. Moreover, CD27 and CD70 mRNA expression in peripheral blood mononuclear cells were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000), and immunostaining indicated that CD27 and CD70 expression in intestinal mucosa were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000). Conclusions CD27-CD70 pathway activated in plasma, peripheral blood mononuclear cells and intestinal mucosa of patients with inflammatory bowel disease. However,plasma levels of CD27 and CD70 can not reflect endoscopic disease activity.

To screen for serum biomarkers for lung squamous carcinoma, two-dimensional gel electrophoresis (2-DE) was performed to separate serum proteins from healthy individuals and stage 1 lung squamous carcinoma(LSC) patients, respectively. PDquest software was used to analyze 2-DE images, and the differential serum protein spots between the healthy individuals and LSC patients were identified by ESI-Q-TOF MS/MS. Then Western blot and immunohistochemistry were used to detect the expression levels of haptoglobin-2(HP-2), one of the differential proteins, in the sera and tumor tissues in the patients with LSC, respectively. 2-DE maps of serum proteins from healthy individuals and stage 1 LSC patients were established. Ten differential serum protein spots were detected, four proteins of which were identified by MS/MS. Western blot showed that the serum level of HP-2 in the LSC patients was significantly higher than that in healthy individuals, but was not associated with LSC staging. Immunohistochemistry showed that the expression level of HP-2 in the LSC tissues was significantly higher than that in the normal bronchial epithelial tissues adjacent to tumors. The results indicated that serum HP-2 protein is a candidate biomarker for LSC, and might be useful for diagnosis of LSC. Up-regulation of HP-2 in the LSC tissues may contribute to the high serum level of HP-2 in the patients.

BACKGROUNDAirway symptoms in asthma are related to decrease of epinephrine secretion, which may be ascribed to elevated nerve growth factor (NGF) in the organism. The aim of this study was to monitor the neuroendocrine alteration in the adrenal medulla of asthmatic rats.

METHODSSixteen rats were randomly divided into two groups (n = 8), control group and asthma group, and the asthmatic rats were sensitized and challenged with ovalbumin (OVA). The levels of NGF, epinephrine and norepinephrine in serum were detected by enzyme linked immunosorbent assay (ELISA), the NGF expression in adrenal medulla was detected by immunohistochemistry, and the changes in the ultrastructure of the adrenal medulla was observed by electron microscopy.

RESULTSThe NGF expression was increased in asthmatic rats compared with control rats. Compared with control rats, the results indicated that the epinephrine level was decreased in asthmatic rats, but no significant difference was found in norepinephrine levels. We found more ganglion cells in the adrenal medulla of asthmatic rats than in control rats, with NGF immunostaining mainly located in these ganglion cells. Electron microscopic images showed the density of chromaffin granula decreased and there was shrunken nucleolemma in the adrenal medullary cells of asthmatic rats.

CONCLUSIONThe innervation of the adrenal medulla is changed in asthmatic rats, and it may contribute to the epinephrine decrease in asthma.

Adrenal Medulla ; metabolism ; ultrastructure ; Animals ; Asthma ; blood ; metabolism ; Bronchoalveolar Lavage ; Enzyme-Linked Immunosorbent Assay ; Epinephrine ; blood ; Male ; Microscopy, Electron, Transmission ; Nerve Growth Factor ; blood ; metabolism ; Norepinephrine ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo demonstrate the vasodilatation activity of the coumarin-containing Angelica dahurica var. formosana and to further analyze active components in the herb extracts.

METHODS(1) The vasodilatation effects induced by different extracts (cyclohexane, ethyl acetate, acetone, methanol, 95 % ethanol and water) of Angelica dahurica var. formosana on mouse thoracic aorta pre-contracted with phenylephrine were investigated. (2) The amount of imperatorin and isoimperatorin in each extract was measured by high-performance liquid chromatography. (3) The vasodilatation effects of imperatorin and isoimperatorin on mouse thoracic aorta were compared using the same in vitro method. (4) The vasodilatation mechanism of imperatorin in the mouse thoracic aorta pre-contracted with phenylephrine was studied using the methods of denuded endothelium, NG-nitro-L-arginine methylester (L-NAME, a nitric oxide synthase inhibitor), and propranolol.

RESULTS(1) The cyclohexane and ethyl acetate extracts of Angelica dahurica var. formosana decreased the maximal response of phenylephrine-induced mouse thoracic aorta contraction dose-dependently, with 50% inhibiting concentration (IC(50)) values of 35.3+/-12.4 mg/L and 40.5+/-12.0 mg/L, respectively. The vasodilatation effect of imperatorin and isoimperatorin was dose-dependent. (2) The cyclohexane extract, showing the strongest vasodilatation effect, possessed the highest contents of imperatorin (4.09%) and isoimperatorin (0.27%, w/w). There was a correlation between the vasodilatation activity and the contents of imperatorin and isoimperatorin in the extracts. (3) The vasodilatation effect of imperatorin was about 4-fold stronger than that of isoimperatorin. (4) The vasodilatation effect of imperatorin was signifificantly attenuated to 24.88%+/-4.06% in the denuded endothelium group compared with the intact endothelium group. And 1 mmol/L L-NAME reduced the imperatorin-induced vasorelaxation by 32.18 %+/-11.29 %.

CONCLUSIONSThe principal effective component of Angelica dahurica var. Formosana was found to be imperatorin. Imperatorin-induced vasodilatation is at least partially regulated by nitric oxide, and has no correlation to beta-receptor.

Angelica ; chemistry ; Animals ; Chromatography, High Pressure Liquid ; Endothelium, Vascular ; physiology ; Furocoumarins ; analysis ; pharmacology ; Male ; Mice ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitric Oxide ; physiology ; Phenylephrine ; pharmacology ; Plant Extracts ; pharmacology ; Propranolol ; pharmacology ; Vasodilation ; drug effects

Objectives: To explore the feasibility of aortic dissection (AD) occlusion via mini-thoracotomy by trans-esophageal echocardiography (TEE) guidance. Methods: Pre-operative TEE was conducted in 2 AD patients, the findings were compared with trans-thoracic echocardiography (TTE) to confirm the diagnosis with quantitative evaluation in order to accurately guiding the wire and sheath pipe into the rupture crevasse of AD for assessing the position, stability and the effect of closure device on local blood flow. Results: TEE confirmed that 2 patients could be treated by interventional plugging and the crevasses of AD were successfully blocked by TEE guidance. Case 1 had DeBakey II AD, crevasse shunt disappeared upon blocking, false lumen formed thrombosis, the diameter reduced form 40 mm to 28 mm and the cavity was retracted about 40%. Case 2 had the ulcer type AD located in aortic arch, closure device was closely suit to aortic wall, spread well and crevasse shunt disappeared;blood flow in aortic arch was about 110 cm/s which was similar at pre- and post-operation, no vascular stenosis and local dilatation were found, vital sign was stable. Follow-up TTE was performed at 1 month after the operation which showed the position of closure devices were normal in both patients. Conclusions: TEE could effectively confirm pre-operative AD diagnosis and provide intuitive image and quantitative information for accurately guiding closure position and evaluating surgical result. Mini-thoracotomy with TEE guidance is feasible for interventional therapy of AD.