Objective To discuss the advance and experience of postoperative management in multivisceral transplantation(MVT).Methods Five patients with abdominal multiple organs malig- nances were subjected to multivisceral transplantation.The excised specimens included the liver,pan- creas,duodenum,stomach,spleen,mesentery and all of the involved lymph nodes.The transplanted organs were liver,pancreas,duodenum and parts of intestine.Patients were monitored and sustained stably in breath,hemodynamics and homoeostasis.The coagulation was also monitored and kept in balance.The intensive immunosuppressive protocol,including steroid,tacrolimus,mycophenolate mofetil and Zenapax,was used to prevent the acute rejection.The endocrine and exocrine of pancreas were tested,color Doppler examination was done every day,and Somatostatin was used to prevent pancreatitis.Drugs to bacteria,fungus and virus infection were prophylactically used.Results All patients waked up with 4-6 h after operation and began recovering with 3-7 days.Dynamic examina- tions revealed that the functions of grafted liver,pancreas and duodenum were satisfactory.No com- plications of acute rejection,pancreatitis,bleeding and thrombosis occurred.Conclusion Many ques- tions in postoperative management related to multivisceral transplantation are devoted to study.Nice experience of management to organ transplantation,detailed monitoring and prophylactically medica- tions are safeguards to steady recovering and further prognosis.

Adolescent ; Bacteria ; isolation & purification ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Respiratory Tract Infections ; microbiology

OBJECTIVETo investigate the distribution characteristics of the single nucleotide polymorphisms (SNPs) in the promoter region of the toll-like receptor 9 gene (TLR9) in Chinese Han children from Zhejiang province, and their associations with asthma susceptibility and phenotypes.

METHODSA case-control study was conducted. A total of 312 asthmatic children aged between 1.9 and 11.6 and 339 age matched healthy controls were enrolled in this study from April 2007 to November 2008. The -1486 C/T in rs187084 and -1237 C/T in rs5743836 loci of the TLR9 gene were genotyped by direct DNA sequencing of the PCR products. Serum levels of IFN gamma, IL-12 and IL-4 were detected by enzyme linked immunosorbent assay.Serum levels of total IgE were detected by chemiluminescence, and serum levels of antigen specific IgE antibodies were detected by fluoroenzymeimmunoassay.

RESULTS(1) The -1486 C/T polymorphism was identified in both groups. The genotype frequencies of TT, TC and CC at -1486 C/T were 41.0%, 44.3%, 14.7% in the healthy controls, and 38.8%, 48.4%, 12.8% in the asthmatic children. The -1237 C/T polymorphism was not detected in the population. (2) There were no statistically significant differences in the allele and genotype frequencies at the -1486 C/T locus between the two groups (P;>0.05). (3) Serum levels of IFN gamma and IL-4 differed significantly among the three genotypes at the -1486 C/T locus in asthmatic children (P<0.01). The CC genotype had the lowest levels of serum IFN gamma and the highest levels of serum IL-4 among the three genotypes. There were no significant differences in these cytokines among the healthy controls (P>0.05). No statistical differences of serum IL-12 were found among the three genotypes in the two groups (P>0.05). (4) There were no significant differences of total IgE (log-transformed) among the three genotypes in the asthmatic children (P>0.05).

CONCLUSIONThe -1237 C/T polymorphism of TLR9 gene was not detected in Chinese Han children in this study. The -1486 C/T polymorphism was associated with the levels of serum IFN gamma and IL-4 in children with asthma. However, there were no correlations between the -1486C/T polymorphism and serum IL-12 levels, total IgE levels or asthmatic susceptibility.

Asthma ; blood ; genetics ; Case-Control Studies ; Child ; China ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Toll-Like Receptor 9 ; genetics

AIMTo observe the effect of phenolic alkaloids of Menispermum dauricum (PAMD) on the hemodynamics, coronary circulation and oxygen metabolism of the myocardium in anesthetized dogs.

METHODSIn this study, the changes of LVSP, LVEDP and +/- dp/dtmax, the flow of coronary artery and myocardial energy metabolism were measured in anesthetized dog with PAMD or NS.

RESULTSIn the anesthetized dogs, compared with pre-treatment status, PAMD at 3.5 and 7.0 mg.kg-1 caused decreases in the left ventricular systolic pressure(LVSP), +/- dp/dtmax, heart rate, the rate of oxygen utilization, the coronary and general peripheral resistance. It was found to increase myocardial oxygen and coronary flow. There were no significant change in the left ventricular end diastolic pressure (LVEDP).

CONCLUSIONPAMD can ameliorate hemodynamics, coronary circulation and myocardial metabolism.

Alkaloids ; isolation & purification ; pharmacology ; Animals ; Blood Pressure ; drug effects ; Cardiac Output ; drug effects ; Coronary Circulation ; drug effects ; Dogs ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Heart Rate ; drug effects ; Male ; Menispermum ; chemistry ; Oxygen Consumption ; drug effects ; Plants, Medicinal ; chemistry ; Random Allocation ; Vascular Resistance ; drug effects

OBJECTIVETo study the central pharmacological effect of the water and chloroform-extract compounds from C. chinese in mice.

METHODThe independent activity test and the hypnotic synergism test by sub-threshold hypnotic dosage of pentobarbital were employed to evaluate the central pharmacological effect of the extract-compounds, and the minimal neurotoxicity was evaluated by the rotorod test.

RESULTthe extract-compounds exhibited significant dose-related inhibition effect of the spontaneous motor activity in mice after intraperitoneal administration. And the two extract-compounds promoted the hypnotic effect by sub-threshold hypnotic dosage administration of pentobarbital, and produced ED50 value of 2.36 g kg (-1) and 0.75 g kg(-1), respectively. Also, both extract-compounds showed no neurotoxicity in the experiment.

CONCLUSIONThe extract compounds from C. chinese showed inhibitional effect on CNS.

Animals ; Central Nervous System ; drug effects ; physiology ; Chloroform ; Cynanchum ; chemistry ; Dose-Response Relationship, Drug ; Drug Synergism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; toxicity ; Female ; Hypnotics and Sedatives ; isolation & purification ; pharmacology ; Male ; Mice ; Mice, Inbred ICR ; Motor Activity ; drug effects ; Pentobarbital ; pharmacology ; Plants, Medicinal ; chemistry ; Random Allocation ; Sleep ; drug effects ; Water

[Objective]To investigate the characteristics of immunophenotypes in hepatocellular carcinoma(HCC) before liver transplantation.[Methods]The immunophenotypes of T-,B- cells,monocytes,dendritic cells(DC)and NK-cells in peripheral blood from 6 HCC patient who were ready to have liver transplantation and 6 healthy volunteers were analyzed by multicolor flow cytometry.[Results]In the patients,the proportions of CD4+PD-1+T cells,Treg cell (CD4+CD25+CD39+T cells),CD19+B cells,Plasmablasts(CD27highCD38highIgD-IgM-),classical monocytes(CD14high CD16-)and mature NK-cells(CD3-CD56high)were all higher than those in the healthy controls(all P<0.05).However, marginal zone B cell(CD27+IgD+),Non-switched B cells(CD27+CD38dimIgM+),intermediate monocytes(CD14high CD16+)and immature NK-cells(CD3-CD56+)were lower than those in the healthy controls(all P<0.05). And there wasn't any obvious difference in quantity being observed among other cell types.[Conclusion]There was difference in the immunophenotypes of immune cells in peripheral blood between HCC patients before liver transplantation and healthy people.And this finding exerts important effects on monitoring the immune status of the patients after liver transplantation and guiding the administrations of immunosuppressors.

Adult ; Cerebral Infarction ; etiology ; prevention & control ; Female ; Humans ; Immunosuppressive Agents ; adverse effects ; Intracranial Hemorrhages ; etiology ; prevention & control ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Tacrolimus ; adverse effects

Background: and Purpose This study aimed to construct an optimal dynamic nomogram for predicting malignant brain edema (MBE) in acute ischemic stroke (AIS) patients after endovascular thrombectomy (ET). Methods: We enrolled AIS patients after ET from May 2017 to April 2021. MBE was defined as a midline shift of >5 mm at the septum pellucidum or pineal gland based on follow-up computed tomography within 5 days after ET. Multivariate logistic regression and LASSO (least absolute shrinkage and selection operator) regression were used to construct the nomogram. The area under the receiver operating characteristic curve (AUC) and decisioncurve analysis were used to compare our nomogram with two previous risk models for predicting brain edema after ET. Results: MBE developed in 72 (21.9%) of the 329 eligible patients. Our dynamic web-based nomogram (https://successful.shinyapps.io/DynNomapp/) consisted of five parameters: basal cistern effacement, postoperative National Institutes of Health Stroke Scale (NIHSS) score, brain atrophy, hypoattenuation area, and stroke etiology. The nomogram showed good discrimination ability, with a C-index (Harrell’s concordance index) of 0.925 (95% confidence interval=0.890–0.961), and good calibration (Hosmer-Lemeshow test, p=0.386). All variables had variance inflation factors of <1.5 and tolerances of >0.7, suggesting no significant collinearity among them. The AUC of our nomogram (0.925) was superior to those of Xiang-liang Chen and colleagues (0.843) and Ming-yang Du and colleagues (0.728). Conclusions Our web-based dynamic nomogram reliably predicted the risk of MBE in AIS patients after ET, and hence is worthy of further evaluation.

BACKGROUNDMagnetic resonance imaging (MRI) is the most sensitive technique for evaluating the healing process and should be performed before the patients return to their exercise routines. The aim of this research was to diagnose chronic lumbago associated with lumbar muscle strain and to monitor healing process by MRI.

METHODSSixty-fve symptomatic cases of chronic lumbago caused by lumbar muscle strain were collected from March 2009 to October 2011. MRI was used to examine, diagnose and monitor the healing process. The control group included 65 random cases of asymptomatic volunteers. MRI methods included routine sequences of GRE T1WI, TSE T2WI and special sequences of T2-STIR-FS, combined with DWI. We compared the MRI characteristics of symptomatic cases before and after healing and with asymptomatic controls.

RESULTSThe important MRI characteristics of chronic lumbago with lumbar muscle strain included: (1) The low back muscle showed edema. (2) The low back intermuscular spaces showed edema and/or fluid. (3) The low back spaces beside the spinous process showed edema and/or fluid. (4) The low back vertebral articular process fossae or transverse process fossae showed fluid. Of these image characteristics, the intermuscular space edema provided the best diagnostic sensitivity, Se = 83%, with YI = 0.63, p = 74%. The low back muscle edema provided the best diagnostic specificity, Sp = 100%, with YI = 0.66, Π = 83%. And the spaces edema beside the spinous process provided the best diangnostic accuracy, Π = 86%, with YI = 0.71, Se = 80%, Sp = 91%. The diagnosis accurate could be improved by combining multiple MRI characteristics. The diagnostic accuracy could achieve Π = 93%, with YI = 0.86, Se = 100% and Sp = 86% when two characteristics were combined. After rehabilitation care, the edema disappeared on the repeated MRI.

CONCLUSIONSMRI may well be a useful diagnostic method for lumbago with lumbar muscle strain. Combining routine sequences with T2-STIR-FS and DWI sequences could demonstrate the pathological changes of lumbar muscle strain and monitor the healing.

Adult ; Chronic Disease ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Low Back Pain ; diagnosis ; etiology ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Sprains and Strains ; complications ; Wound Healing

OBJECTIVETo investigate the association between single nucleotide polymorphisms (SNPs) in cyclic adenosine monophosphate response element-binding protein(CREB1) gene and major depressive disorder (MDD).

METHODSWe recruited 105 parent-offspring trios of Chinese descent, extracted whole blood genomic DNA, and genotyped the SNPs in rs10932201 and rs6740584 loci. Single-marker transmission disequilibrium test (TDT), pairwise SNP linkage disequilibrium(LD) and haplotype-based TDT were performed.

RESULTSNo significant association with MDD was observed for SNPs rs10932201 and rs6740584 (P=0.1004 and P=0.4986). However, there was strong positive association between the rs10932201-rs6740584 haplotype and MDD (P=0.00003241), and both haplotypes of A-C and A-T were significantly associated with MDD (P=0.020 and P=0.00022).

CONCLUSIONThe rs10932201-rs6740584 haplotype of the CREB1 gene may play an important role in the pathogenesis of MDD.

Cyclic AMP Response Element-Binding Protein ; genetics ; Depressive Disorder, Major ; genetics ; Female ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Male ; Polymorphism, Single Nucleotide ; genetics