Objective To observe the variety of liver and kidney function during lung transplantation and discuss its reference value of diagnosis and therapy in clinical acute rejection(AR).Methods The variety of TBIL, ALT and CRE were dynamically studied and analyzed before and after lung transplantation in 2 cases shared one same donor's lung block.Results During the use of CSA,TBIL diversely procedurally raised and it got right when AR was under control; when illness was worsen,ALT abnormally raised and CRE had no remarkably change.Conclusion TBIL is the sensitivity index of hepatotoxicity of immunity inhibitor CSA after lung transplantation. The abnormal change of ALT is the index of disease turnover.

DNA damage response (DDR) in different cell cycle status of human peripheral blood lymphocytes (PBLs) and the role of H2AX in DDR were investigated. The PBLs were stimulated into cell cycle with phytohemagglutinin (PHA). The apoptotic ratio and the phosphorylation H2AX (S139) were flow cytometrically measured in resting and proliferating PBLs after treatment with camptothecin (CPT) or X-ray. The expressions of γH2AX, Bcl-2, caspase-3 and caspase-9 were detected by Western blotting. DDR in 293T cells was detected after H2AX was silenced by RNAi method. Our results showed that DNA double strand breaks (DSBs) were both induced in quiescent and proliferating PBLs after CPT or X-ray treatment. The phosphorylation of H2AX and apoptosis were more sensitive in proliferating PBLs compared with quiescent lymphocytes (P<0.05). The expression levels of anti-apoptotic proteins Bcl-2 were reduced and cleaved caspase-3 and caspase-9 were increased. No significant changes were observed in CPT-induced apoptosis in 293T cells between H2AX knocking down group and controls. It was concluded that proliferating PBLs were more vulnerable to DNA damage compared to non-stimulated lymphocytes and had higher apoptosis rates. γH2AX may only serve as a marker of DNA damage but exert no effect on apoptosis regulation.

Objective To investigate the demethylation and changes in gene expression of programmed death receptor-1 ( PD-1) caused by methylation inhibitor 5- azacytidine (5-Zac) in lymphocyte series Molt-4 cells and its mechanism. Methods Molt-4 cells were cultured in different concentrations of 5-Zac(0, 5, 10 Umol/L)for 72 h, ratio of cell expressing PD-1 and apoptosis rate were detected by FCM, transcription of PD-1 gene mRNA was detected by RT-PCR. Molt-4 cell DNA of all groups were disposed by sodium bisulfite, PD-1 gene promoter fragment binded with transcription factor Brn-2 was amplified by PCR,these amplification fragments were transformed into E. coli. Positive clones were selected by sequencing,methylation status of the fragments binded with transcription factor Brn-2 was examined. Results S-Zac could increase the PD-1 expression of Molt-4 cells. PD-1 expression rate in 0 μmol/L 5-Zac( 1. 13%±0.01% ) treated cells was found more lower than that in both 5 μmol/L and 10 μmol/L 5-Zac treated cells (18. 96% ±1. 87% , 63. 09% ± 6. 25% , P < 0. 05 ) , and they showed concentration-dependent (P <0.01). Cells apoptosis rate and PD-1 mRNA expression were also observed increased significantly with 5-Zac treating. Demethylation probability of CG points showed significant difference between transcription factor Brn-2 binding site and other four locations (P < 0.05 ). Conclusion 5 -Zac inhibits cell grouth in human lymphoid cell series Molt-4 by inducing PD-1 gene expression and promoter demethylation. PD-1 gene promoter binding transcription factor Brn-2 fragment CG point demethylation may be one of the important mechanisms in 5-Zac treated Molt-4 cells.

Objective To evaluate the effectiveness of single balloon enteroscopy (SBE) in diagno-sing of suspected lesions in small intestine. Methods Data of 23 patients with suspected small intestinal disease, who underwent SBE (Olympus) between February 2009 and August 2009, were retrospectively studied. A total of 34 procedures were performed in 23 patients. The indications for the examination were suspected obscure gastrointestinal bleeding (n = 9), abdominal pain (n = 7), suspected intestinal tumor re-vealed by capsule endoscopy (n = 4), and Crohn disease (n = 3). Results The average preparation time of SBE was less than 5 minutes. The mean procedure time was 61±25 minutes and 67±28 minutes for the oral and anal routes, respectively. Examination of whole length of small intestine was achieved in 6 patients. The diagnostic rate of small-intestinal lesions was 60. 9%, and no severe complications including perforation occurred. Conclusion SBE is safe and easy to prepare and perform, which can be a useful diagnostic and therapeutic tool for suspected small bowel disease.

This study aimed at comparing the precise powder decoction pieces and market raw TCM slices of P.cacumen over the decocting quality.ITS2 sequence was adopted as a DNA barcode to identify P.cacumen.The chemical composition of the medicinal materials was characterized by HPLC fingerprints for the evaluation of the similarity of precise powder decoction pieces and market TCM slices.The concentrations of quercitrin were determined using UPLC,and the characteristic common peaks were identified.In addition,the extraction efficiency between the market TCM slices and the precise powder decoction pieces was also compared by standard decoction method.It was found that P.cacumen was accurately identified by ITS2 sequences.HPLC fingerprints showed that the extraction efficiency and similarity of the precise powder decoction pieces increased compared with the market TCM slices.However,the extraction yield rate of the precise powder decoction pieces was improved by 20％ increased in accordance with the standard decoction method,while the contents of the index component,quercitrin,presented rare increase and the decocting rates of the other chemical components little change in the study.In conclusion,it was indicated that precise powder decoction pieces improved the extraction efficiency and uniformity in comparison with TCM slices.

This study aimed at evaluating the quality of precise powder decoction pieces (PPDP) of E.Folium (EF) compared with the traditional commercial slices by chemical fingerprint methods and DNA molecular identification technology.Different specifications of PPDP were prepared,and their dry extract contents were in contrast with that of commercial slices.The slices of EF were identified using ITS2 and psbA-trnH sequences.Three batches of commercial slices were collected,and the content uniformity,fingerprint and similarity evaluation before and after the mixing and pulverization were detected by HPLC-DAD and DNA sequence alignment.It was found that the paste rate of PPDP was slightly higher than that of the traditional commercial slices.The dissolution of chlorogenic acid of PPDP was higher than that of the traditional commercial slices.RSD of inter-assay dissolutions of chlorogenic acid of commercial slices was 15.56％,which was reduced to 6.82％ after mixing and preparing into PPDP.The fingerprints showed that the similarity of the PPDP of EF was elevated with the inceases of 10 marketed common peaks.The PPDP of EF was accurately identified by ITS2 and psbA-trnH sequences.In conclusion,compared with traditional commercial slices of EF,the PPDP apparently improved the dissolution rate and the quality uniformity,demonstrated that the boiled powder of CRP achieved obvious clinic advantages.

This study aimed at investigating the drug preparation of precise powder decoction pieces (PPDP) system,Fallopia multiflora radix preparata (FMRP) was employed in this study.Different specifications of PPDP were prepared,their extract rates were in contrast with the original pieces.Compared the quality uniformity of three batches between FMRP original slices and its PPDP extraction,the similarity of the chemical fingerprints was evaluated,and the contents of common peaks and quality uniformity were compared by relative peak areas.ITS2 sequence was taken as a DNA barcode to identify F.multiflora radix (FMR).As a result,the extract rate of PPDP was 2.5 times as much as the original slices.The average content of stilbene glucoside from the three original slices and the PPDP extraction were 3.56 ± 2.61 and 13.23 ± 0.37 mg·g-1,respectively;while the RSD were 73.28％ and 2.82％.The similarity of the fingerprints of the PPDP extraction was almost the same as that of the original slices,but the content and the uniformity of the common peaks of the PPDP extraction were significantly improved.Thus,FMR was accurately identified using ITS2 sequences.It was concluded that the PPDP considerably improve the decocting rate and quality uniformity,indicating that PPDP could save resources and improve the clinical efficacy.

Objective:To compare the clinical outcomes between OTA/AO-C open and closed fractures of the distal humerus treated by open reduction and internal fixation.Methods:The clinical data were retrospectively analyzed of the 70 patients who had been treated at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital for OTA/AO-C fractures of the distal humerus from January 2014 to June 2017. Of them, 22 suffered from open fractures (Gustilo types Ⅰ/Ⅱ) and 48 closed fractures. There were 18 males and 4 females with an age of (42.6±13.0) years in the open group and 21 males and 27 females with an age of (42.2±17.1) years in the closed group. Analyzed were interval from injury to surgery, hospitalization time, injury energy and functional outcomes which included range of motion (ROM) in elbow flexion and extension, ROM in elbow rotation, Mayo elbow performance score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), complications and rate of secondary surgery.Results:There was no significant difference between the 2 groups in age, injury energy or interval from injury to surgery ( P>0.05), but there were significantly more males in the open group than in the closed group ( P=0.011). The follow-up time for all the patients averaged 34.0 months (from 25 to 54 months). There were no statistically significant differences between the 2 groups in hospitalization time [9.5(6.0, 13.0) d versus 8.5 (6.0, 11.0) d], ROM in flexion and extension [120.0° (100.0°, 137.8°) versus 128.5° (110.0°, 140.0°)], ROM in rotation [155.0° (151.3°, 155.0°) versus 155.0° (155.0°, 155.0°)], MEPS [95.0 (80.0, 100.0) versus 95.0 (80.0, 100.0)] or DASH [2.6 (0.63, 9.2) versus 1.7 (0.0, 8.5)] ( P>0.05). There were no statistically significant differences between the 2 groups either in rate of secondary surgery [36.4% (8/22) versus 33.3% (16/48)], ulnar nerve symptoms [54.5% (12/22) versus 60.4% (29/48)], local irritability in the region of internal fixation [9.1% (2/22) versus 6.3% (3/48)] or elbow stiffness [13.6% (3/22) versus 10.4% (5/48)] ( P>0.05). Conclusion:Open reduction and internal fixation can lead to similar clinical outcomes in the treatment of both open (Gustilo types Ⅰ/Ⅱ) and closed distal humeral fractures of OTA/AO-C, with no significant differences in postoperative ROM, functional scores or complications.

Objective To compare the efficacy and safety of E1B gene-deleted adenovirus (H101)and ethanol in treating advanced pancreatic carcinomas by intratumoral injection combined with intravenous gemcitabine.Methods We constructed an orthotopic nude mouse model of pancreatic carcinoma through cancer cell injection into pancreas.A total of 54 nude mice were randomly allocated to 6 groups to accept H101,ethanol or saline (control) intratumoral injection,combined with or without intravenous gemcitabiein.The animals were sacrificed 4 weeks after the treatment and the pancreatic tumors were collected to determine the size,existence of metastasis,distribution of virus by indirect immunofluorescence and apoptosis in tumor by TUNEL and electron microscope.Results All mice completed the scheduled treatment,while 3 died in 48 hours after ethanol injection resulting in a mortality of 16.7％ (3/18).On the contrary,no mice died in the adenovirus injcction group.The average tumor size in group of H101 intratumoral injection combined with intravenous gemcitabie was significant smaller than that in group of saline injection with or without systemic gemcitabie (P =0.008,0.040,respectively).Similar differences were observed between ethanol intratumoral injection and control groups (P =0.012,0.041).Meanwhile,the H101 was absent in all the other organs except the pancreas,which meant that the selectivity of the H101 was tremcndous.The virus combine gemcitabie group had higher apoptosis rate in tumor (83.2 ± 35.7) ％,determined by TUNEL.Conclusion E1B gene-deleted adenovirus intratumral injection in combination with intravenous gemcitabine treating pancreatic carcinomas is efficient and safe,in spite of its lower effectiveness than ethanol.

100 U/L were higher than those in group of CK-MB≤100 U/L(P