A male patient aged 23 years with chronic renal failure,who were treated with sequential living related donor kidney transplantation/nonmyeloablative syngeneic hematopoietic stem cell transplantation,were selected in April 2000 at the 153 Central Hospital of Chinese PLA.Donor is his mother.Nonmyeloablative syngeneic hematopoietic stem cells were transplanted after kidney transplantation.Microchimera in the recipient,rejection,infection and graft-versus-host reaction and dosage of immunodepressant were detected,and then compared with the control.Different nursing care plans were performed following different therapies.HLA-DR site,the same as the donor,could be detected in the recipient after 3 months,and present after 3 years.Immunodepressant dosage was half of that in subjects who did not receive hematopoietic stem cell transplantation.No rejection occurred during the 7 years follow-up.Microchimera or immunotolerance can be detected in the recipient following sequential living related donor kidney transplantation/nonmyeloablative syngeneic hematopoietic stem cell transplantation.

ObjectiveTo investigate the quality of life in patients with ankylosing spondylit2s(AS). Method86 patients were investigated by direct questioning using a uniform questionaire. ResultAll patients had different degree of stiffness on the lower back. 77.9% and 75.8% ofpatients ftequently had pain and fatigue respectively. 24. 4% of patients had sleeping disorder. 39.5% of patients had to change job or could notundertake normal work. 86% of patients had limitations in participating social activities. irritable feelings developed in 94. 1% of patients.91.8% of patients were not regularly treated before being admitted . ConclusionAll patients had few imitation in self- care and elementaryactivities in self - care. Most patients could perform their house hold tasks, although their severe symptoms have periodically flares. Many patientshad psychological problems.

Objective To study endostatin expression in tumor tissues and serum levels of bladder cancer patients. Methods Expression of endostatin in 45 cases of bladder cancer and 12 subjects with normal bladder tissues was examined immunohistochemically.Serum levels of endostatin in 58 patients with bladder cancers and 43 healthy controls were analyzed by competitive enzyme immunoassay. Results Positive expression of endostatin was found in 61.5% patients with superficial bladder cancer,90.6% with invasive bladder cancer and 33.3% in normal bladder tissues.Serum level of endostatin was significantly higher in patients with bladder cancer than that in healthy controls (P

Objective To investigate the mechanisms of calculus crystal transport by macro-phage in kidney. Methods Hyperoxaluria rat model was established by administration of 1% ethyl-ene glycol and 1% ammonium chloride in drinking water. 24 h rat urine was collected, urinary oxalate were analyzed by ion chromatography. The expression and location of osteopontin and macrophage in kidney were observed by immunohistochemistry. Macrophage and calculus crystal at the basement membrane of renal tubular epithelial cells and interstitium were observed. Results The urinary ox-slate concentration were (0.22±0.13), (0.29±0.08), (0. 50±0.26), (0. 41±0. 22), (0.25±0. 12) ng/ml among these 5 groups. The osteoponitin expression was 0.16±0.04, 0.25±0.09, 0.37±0.10, 0.23±0.08, 0.19±0.02 respectively. The expression of osteopontin was positively correlated with urinary oxlate concentration(r=0.887, P<0.05). The macrophage at the basement membrane of renal tubular epithelial cells was 0.12±0.08, 0.19±0.06, 0.27±0.04, 0.16±0.03, 0.18±0.03 respectively. The macrophage distribution was positively correlated with the expression of osteopontin (r= 0.596, P<0.05). The macrophage moved from vessel to the basement membrane of loops of Henle, then disrupted and released the calculus crystal. Conclusions The macrophage might take part in the calculus crystal transport in kidney at the basement membrane of loops of Henle, which may be the source of Randall plaque. This process may be mediated by osteopontin.

Objective To compare the diagnostic efficiency of superb microvascular imaging (SMI) and contrast-enhanced ultrasonographic microvascular imaging (MVI) for differentiating breast lesions.Methods One hundred and sixteen patients with 116 breast lesions were first examined by grayscale ultrasound.Then SMI and MVI were performed on all patients.Microvascular architectures of breast lesions were depicted by both methods.The lesions were evaluated based on their microvascular architectures.The diagnostic efficacy of both methods were compared.Results The diagnostic sensitivity,specificity,and accuracy of SMI and MVI were 79.24％,90.48 ％,85.35％ and 88.68％,87.30％,87.93％,respectively.The areas under the curve of SMI and MVI were 0.888 and 0.926.The diagnostic values of SMI and MVI were not statistically different (P =0.212).Conclusions SMI can detect tiny vessels and depict microvascular architecture of breast lesions as MVI do,which is beneficial for breast tumor differentiation.The diagnostic efficacy of SMI is almost the same as MVI.

Objective To investigate the influence of social support on the depression and anxiety of standardized training residents.Methods Three hundred and eighteen standardized training residents selected by random sampling method from 4 training bases in Shanghai participated in this survey.ResultsThe average score of PHQ-9 was(7.24±5.20), and 67.30%(n=214)of participants had different degrees of depression;the average score of GAD-7 was(5.57±4.55), and 55.03%(n=175)of participants had different degrees of anxiety.One-way analysis of variances showed that standardized training residents who had work experience, longer training years and less salary satisfaction got higher scores in PHQ-9 and GAD-7.Male physicians had higher scores in GAD-7 than female ones.The scores of PHQ-9 (r=-0.390, P<0.01) and GAD-7 (r=-0.376, P<0.01) were both negatively correlated with social support.Regression analysis showed that training years,salary satisfaction,objective social support and the availability of support were significant for predicting the scores of PHQ-9(adjusted R2=0.242,F=17.893), work experience, salary satisfaction,objective social support and the availability of support were significant for predicting the scores of GAD-7(adjusted R2=0.228,F=14.390).After controlled the demographic variables, social support explained the variation rate of 0.119 to the score of PHQ-9 and 0.126 to the score of GAD-7.Conclusion The depression and anxiety of standardized training residents in this study is in a serious situation.Providing the objective social support and the availability of support as well as improving the salary satisfaction of standardized training residents may relieve the depression and anxiety and enhance their mental health.

Objective To investigate the effect of cyclooxygenase-2(COX-2) inhibitor celecoxib on bladder cancer xenografts in nude mice and apoptosis of tumor cells in the xenografts. Methods Models of bladder cancer xenograft in nude mice was used to observe the effect of celecoxib on the animals and the xenografts.TUNEL was used to assess apoptotic index of tumor cells in the xenografts. Results Celecoxib could effectively inhibit the growth of xenografts(P0.05). Conclusions Celecoxib maybe inhibit the growth of bladder cancer via inducing apoptosis of tumor cells and perhaps will become a choice of chemoprevention and adjuvant therapy of bladder cancer.

AIM: To investigate the protective effect of taurine on kidney in a rat model of calcium oxalate nephrolithiasis.METHODS: Animal model of calcium oxalate nephrolithiasis was established by administration of 2.5% ethylene glycol+2.5% ammonium chloride 2 mL two doses daily to adult male Sprague-Dawley rats in company with restriction of drinking water intake for 4 weeks.Four groups of 8 rats each were studied: group A,untreated control animals;group B,nephrolithiasis without treatment;group C,nephrolithiasis with taurine(2.0% mixed with the chow);group D,only taurine(2.0% mixed with the chow).Intake of drinking water in each group for each rat was limited to 20 mL/d.Indexes of oxidative stress(OS) and renal injury in urine and kidney,and the enzymatic activities of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in mitochondria of homogenized kidney samples were assessed at the day when the rats were sacrificed.Crystals deposited in kidney were scored under light microscopy.Renal tubular ultrastruture changes were analyzed by transmission electron microscopy.Expression of macrophage cell marker CD68 in kidney was evaluated by immunohistochemistry.RESULTS: Compared to the control group,oxidative stress and renal injury were developed after induction of nephrolithiasis,in accordance with increase in expression of CD68 in kidney.The enzymatic activities of SOD and GSH-Px in mitochondria were decreased significantly.Administration of taurine significantly reduced OS and renal injury,as well as the crystals deposited in kidney.Expression of CD68 in kidney was also reduced,while the enzymatic activities of SOD and GSH-Px in mitochondria were improved significantly.CONCLUSION: Attributed to its antioxidant capacity,taurine showed renal protective action in this rat model of calcium oxalate nephrolithiasis.

Objective To investigate the relationship between satisfaction of nursing service and nurses' personality and mental state.Methods 368 nurses ,288 patients and 234 dependents involved the investigation.Minnesota Multiphasic Personality Inventory(MMPI)was used to analyze nurses' personality.Symptom Checklist-90(SCL-90),Self-rating Depression Scale(SDS) and Self-rating Anxiety Scale(SAS)were used to analyze nurses' mental states.A self-made questionnaire on satisfaction was used to investigate the satisfaction degree of patients and dependents with nursing service.The data were analyzed by descriptive statistics and multiple regression analysis.Results The average score on satisfaction with the nurses' service was(8.29±0.98)and the average score on satisfaction with nurses' attitude was(8.19±1.21).The satisfaction with nurses' service was negatively correlated with the MMPI factors of manifest anxiety and dependency and positively with dominance of MMPI(both P<0.05).Satisfaction with nurses' attitude was negatively correlated with total score of SAS,dependency of MMPI,compulsion,anxiety,hostility and paranoid ideation of SCL-90(all P<0.05).Satisfaction with the service attitude was positively correlated with social responsibility of MMPI(P<0.05). Conclusion Satisfaction degree of patients and their dependents is related to nurses' personality and mental states.It's helpful to establish good relationship between nurses and patients and improve the clinical nursing service to perfect nurse's personality and relieve psychological stress on nurses.

Objective:To compare the clinical outcomes between pedicle screw internal fixation via the Wiltse approach and conservative treatment in young patients with thoracolumbar fracture with Thoracolumbar Injury Classification and Severity score (TLICS) ≤ 4 points.Methods:This retrospective study included 219 young patients with thoracolumbar fracture with TLICS score ≤ 4 points who had been treated from January 2014 to December 2018 at Department of Orthopaedics, The Second Hospital of Shanxi Medical University and obtained full follow-up. They were assigned into a surgery group of 126 patients subjected to pedicle screw internal fixation via the Wiltse approach and a conservative group of 93 patients subjected to conservative treatment. The surgery group included 65 males and 61 females, aged from 18 to 37 years, with a TLICS score of 1 point in 38 cases and of 2 to 4 points in 88 ones; the conservative group included 48 males and 45 females, aged from 19 to 38 years, with a TLICS score of 1 point in 29 cases and of 2 to 4 points in 64 ones. Patients in both groups underwent thoracolumbar X-ray, CT and MRI before treatment and regular thoracolumbar X-ray reexamination after treatment. Improvements in visual analog scale (VAS) for low back pain were compared between pre- and post-treatment. The 2 groups were compared in terms of VAS, anterior height of the injured vertebra and kyphosis cobb angle between pre-treatment, one month post-treatment and the last follow-up.Results:The 2 groups were comparable due to insignificant differences between them in the pre-treatment general data ( P>0.05). In the surgery group, patients were followed up for 24 to 72 months, the average VAS scores at one month post-treatment (2.5±1.2) and the last follow-up (2.3±0.8) were significantly improved compared to the pre-treatment value (6.8±2.1) ( P<0.05), and no serious surgical complications occurred. In the conservative group, patients were followed up for 30 to 65 months, the average VAS scores at one month post-treatment (3.9±1.9) and the last follow-up (3.5±0.9) were significantly improved compared to the pre-treatment value (6.2±2.0) ( P<0.05), and the rate of complications was 11.8% (11/93, including 3 cases of neural symptoms of the lower limb, 4 cases of bedsore and 4 cases of pulmonary infection). The VAS, anterior height of the injured vertebra and kyphosis cobb angle at one month post-treatment and the last follow-up in the surgery group were all significantly better than in the conservative group ( P<0.05). Conclusion:In young patients with thoracolumbar fracture with TLICS ≤ 4 points, pedicle screw internal fixation via the Wiltse approach can lead to better therapeutic outcomes than conservative treatment, especially in relief of postoperative low back pain.