Objective To investigate the effects of panax notoginseng saponins(PNS) on the expression of IL-10 and TNF-α in the brain after focal cerebral ischemia-reperfusion injury in rats,and the mechanism was explored.Methods 30 male adult Sprague-Dawley rats were randomly divided into sham-operation group,ischemia-reperfusion group and PNS treatment group,10 rats in each group.The middle cerebral artery occlusion(MCAO) was established with ischemia-reperfusion group.The rats received continuous gastric lavage for 4 weeks,who were observed for 3 days and then killed to the detect the expression of IL-10 and TNF-αin ischemic region by ELISA,immunohistochemistry and RT-PCR.The behavioral ability score in rats were tested.Results Compared with the sham-operation group and ischemia-reperfusion group,the expression of IL-10 was increased,while the expression of TNF-α was decreased significantly in PNS treatment group,behavior score of PNS treatment group increased significantly than that of ischemia-reperfusion group.Conclusion The panax notoginseng saponins can reduce the neurons injury after focal cerebral ischemia-reperfusion injury in rats partly by regulating the expression of IL-10 and TNF-α in the brain.

[Objective]To evaluate the effectiveness of posterior lumbar interbody fusion(PLIF) in the treatment of upper lumbar disc herniation.[Method]Twenty six patients of upper lumbar disc herniation underwent posterior lumbar interbody fusion,lumbago VAS and the pain in waist and lower extremities grades were tested before operation,all patients had an average follow-up period of 20.8 months,then lumbago VAS and the pain in waist and lower extremities grades were tested at last follow-up,lumbago VAS and the pain in waist and lower extremities grades were compared through paired t-test.[Result]All 26 patients had a followed-up.Postoperative VAS had significant lower than preoperative,statistical analysis has remarkable significance(P

Objective To investigate the clinical effects of diltiaze in renal transplantation patients treated with cyclosporine A (CsA). Methods 1529 renal transplant cases were randomly ~divi -ded into experimental group 1 receiving CsA, Aza, Pred and Diltiaze, experimental group 2 receiving CsA, MMF, Pred and diltiaze, and control group receiving CsA, Aza and Pred without diltiaze. The dosage and blood concentrations of CsA, the outcome of renal transplant, the incidence of acute rejection, and the hepatic and renal toxicity were observed in the experimental groups and control group.Results The dosage of CsA in experimental group 1 was less, while the blood concentrations of CsA was higher than in control group (P~0.05 ). The recovery time of the graft function was cut down to 4.7 days (experimental group 1) and 3.9 days (experimental group 2) respectively with the difference being significant between the experimental groups and control group (P

Objective To study the mechanism of acute rejection of human renal transplantation and detect the sensitive markers for early diagnosis of acute rejection. Methods Immunohistochemistry was used to detect the expression of Perforin and Granzyme B molecules during acute rejection in the renal grafts. The immunocytochemical ABC assay and flow cytometry ways were used to detect the expression of Perforin and Granzyme B molecules in peripheral blood. Results Perforin and Granzyme B molecules were increased in all tissue specimens and lymphocytes of peripheral blood during acute rejection. There was a correlation between the Granzyme B and histological changes ( P

Objective To discuss the way of treating accelerated rejection. Methods Seven patients of accelerated rejection were treated by efficient anti-rejection treatment. ResultsSix patients of accelerated rejection were reversed by efficient treatment of anti-rejection. One allograft was removed because treatment was invalid. And six patients were still alive, the longest survival one has reached to 3 years. ConclusionThe treatment emphasis of accelerated rejection should be focused on 3 aspects, including early diagnosis, efficient treatment in time, and paying more attention to any possible complications during the process of treatment.

ObjectiveTo explore the value of three-dimensional speckle tracking (3DT-STI) technique for evaluating end-systolic three-dimensional longitudinal strain (3DLSe) of left ventricular myocardium in patients with left anterior descending coronary artery (LAD) lesions.MethodsSixty patients with pure LAD lesions diagnosed by coronary artery angiography (CAG) in Taizhou Hospital from June 2012 to December 2014 were enrolled, including 30 patients with acute anterior wall myocardial infarction (infarction group) and 30 patients without acute anterior wall myocardial infarction (non-infarction group). Sixty patients in the control group were enrolled in Department of cardiology in Taizhou Hospital in the same period. 3DLSe within LAD blood-supplied region, adjacent region and remote region were analyzed in all cases using 3DT-STI. The 3DLSe differences of 3 groups were compared by one-way analysis of variance, and the 3DLSe differences between two groups were compared by the LSD-t test. The inter-observer and intra-observer consistency of 3DLSe of left ventricular myocardium were analyzed by Bland-Altman drawing analysis method.Results3DLSe of all 7 segments within LAD blood-supplied region were lower in infarction group than those of non-infarction group and control group, and the differences were statistically significant (infarction groupvs. control group:t values were 6.96, 7.41, 8.94, 8.23, 8.94, 12.09 and 15.99, respectively,P values were all less than 0.01; infarction groupvs. non-infarction group:t values were 5.30, 5.50, 4.66, 4.32, 4.66, 7.66 and 10.11, respectively, P values were all less than 0.01); 3DLSe of middle anterior segment, middle anterior septal segment, apical anterior segment, apical septal segment and apex of heart within LAD blood-supplied region were lower in non-infarction group than those of control group, and the differences were statistically signiifcant (t values were 3.56, 3.23, 3.02, 3.25 and 4.36, respectively,P values were all less than 0.01), but 3DLSe of basal anterior segment and basal anterior septal segment had no statistically significant difference. 3DLSe of basal inferior septal segment within LAD adjacent region had no statistically significant difference in all 3 groups. 3DLSe of basal lateral segment, middle inferior septal segment, middle lateral segment, apical inferior segment and apical lateral segment within LAD adjacent region were lower in infarction group than those of non-infarction group and control group, and the differences were statistically signiifcant (infarction groupvs. control group:t values were 4.15, 4.79, 4.58, 9.24 and 12.07, respectively,P values were all less than 0.01; infarction groupvs. non-infarction group:t values were 2.66, 3.59, 4.29, 7.74 and 10.33, respectively,P values were all less than 0.01); but 3DLSe of basal lateral segment, middle inferior septal segment, middle lateral segment, apical inferior segment and apical lateral segment within LAD adjacent region had no statistically significant difference between non-infarction group and control group. 3DLSe of all 4 segments within remote region had no statistically significant difference. Bland-Altman drawing analysis method showed the mean inter-observer and intra-observer difference of 3DLSe of left ventricular myocardium were-0.3% and-0.2%, the 95% conifdence interval (CI) were in the range of (-5.6%, 5.0%) and (-8.2%, 7.7%), respectively. It was demonstrated that 3DLSe of left ventricular myocardium had good inter-observer and intra-observer consistency.Conclusions3DLSe of left ventricular myocardium can detect the subtle changes in myocardial systolic function and is more sensitive than the conventional echocardiography. It can localization and analyze quantitatively the range of myocardial ischemia or infarction and has good consistency.

Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1％),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P＜0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P＜0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P＜0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.

Objective To study the expression of immunoglobulin-like transcripts 3 (ⅡT3) and ILT4 in peripheral blood dendritic cells (DC) of kidney transplantation recipients and to analyze its significance in immunity hyporesponsiveness of transplantation. Methods Twenty kidney allograft recipients who were survived more than five years were recruited to two groups: renal function stable groups, chronic rejection groups, and 10 healthy volunteers served as a control group. The peripheral blood mononuclear cells (PBMC) were stimulated with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin 4 (IL-4) and immature DC were obtained. The expression of ILT3 and ILT4 was detected by using flow cytometry. The level of HLA-G5 in serum was determined by using enzyme linked immunosorbent assay. Results ILT3 expression in renal function stable group was increased and decreased in chronic rejection groups as compared with control group (P＜0.05),but ILT4 expression had no significant difference among all groups. HLA-G5 in serum was significantly increased in renal function stable group as compared with other groups. Conclusion Expression of ILT3 and HLA-G was increased in the kidney transplantation recipients with stable renal function and long-term survival, suggesting that they may play an important role in inducing and maintaining periphery immune tolerance.

Objective To explore the clinical effect of renal transplant from donation after citizen's death (DCD) donors with acute kidney injury (AKI).Methods This was an observational retrospective study of 622 patients who underwent renal transplantation from 312 DCD donors' kidneys at the First Affiliated Hospital of Xi'an Jiaotong University from December 2011 to December 2016.The transplant patients were divided into AKI group and non-AKI group according to the Acute Kidney Injury Network (AKIN) criteria based on initial and terminal creatinine values.We evaluated and compared transplant outcomes of these two groups.Results There were 131 donors with AKI,and the incidence of AKI was 42.0 ％.AKI group and non-AKI group recipients respectively had DGF in 20.2％ and 7.2％ of cases (P＜0.01),153.6 ± 56.2 and 119.3 ± 40.7 μmol/L of serum creatinine (SCr) levels at 1st month (P＜0.01),and 38.5 ± 14.1 and 57.6 ± 23.4 ml· min-1 (1.73 m2)-1 of eGFR at 1st month (P＜0.01).There was no significant difference in SCr and eGFR between two groups at 1st year after transplantation.Conclusion Most of kidneys from DCD donors with AKI can be considered for transplantation.Renal transplantation of organs from DCD donors with AKI showed greater DGF but good outcomes.

Aim: A new derivative LC-MS method was developed for the simultaneous determination of zofenopril and its active metabolite zofenoprilat to investigate the pharmacokinetic characteristics of zofenopril and zofenopri-lat in healthy Chinese volunteers after single and multiple oral doses of zofenopril calcium tablets. Methods: Ten Chinese healthy volunteers were given three single oral doses of 15,30, and 60 mg, respectively, and consecutively the multiple doses of 30 mg. The concentration and pharmacokinetic parameters of both the parent drug and the active metabolite were simultaneously determined by derivative LC-MS method using p-bromophenacyl bromide (p-BPB) as the derivative reagent. Results: After the single oral administrations of 15, 30, and 60 mg of zofeno-pril calcium, there was no significant difference in the t_(1/2) of both zofenopril and zofenoprilat among the three do-ses. The values of AUC_(0-24h) and c_(max) for both zofenopril and zofenoprilat showed the good linearities to the dosage over the dose range from 15 mg to 60 mg. There were no significant differences in AUC_(0-24h) and c_(max) for both com-pounds between female and male volunteers. After multiple oral administration( 30 mg once daily for 6 days ), the average steady state plasma concentration( c_(av)) for zofenopril was (5. 07 ±1. 06) ng/mL with the degree of fluctu-ation (DF) of 14. 26 ± 2. 94. The c_(av) for zofenoprilat was (6. 28 ± 1. 87) ng/mL with the DF of 11. 61 ±4. 68. The accumulation index values for zofenopril and zofenoprilat were 0. 94 ± 0. 31 and 0. 83±0. 13, respec-tively. Conclusion: Both zofenopril and zofenoprilat were demonstrated of linear kinetics after single administra-tion and showed no accumulation after multiple administration of the test zofenopril calcium tablets. There was significant difference in the pharmacokinetic characteristics for zofenopril calcium between healthy Chinese and European volunteers.