Clinical and pharmacological researches have been carried on traditional Chinese medicine (TCM) used in the treatment for hypertension from single Chinese raw dosage form to complex compound in recent years. It is found that TCM’s effects mainly focus on integral regulation for human being’s health. Besides depressing blood pressure, furthermore, TCM also have lots of efficacy in other aspects, such as relieving left ventricular hypertrophy (LVH), improving function of vascular endothelial cell and atherosclerosis, protecting kidney function, decreasing disability rate as well as enhancing quality of life. In a word, TCM should be used in preventing and treating hypertension as early as possible.

Objective To sum up the clinical experience of liver retransplantation (ReTx).Methods All recipients were male. The average age was 50 years old (43-55). The indications included primary nonfunction (PNF) (1 case), acute rejection (1 case), chronic rejection and biliary infection (1 cases) and ischemic type billiary lesion and biliary infection (2 cases). The blood types of recipients and donors were identical. All donors were heart arrest. The immunosuppressive protocols included Zenapax and methylpredinisone (MP) and FK506. MMF was added if necessary.Results Three patients were cured. Two patients died at 8th and 10th day. One died of serious infection and failure of multiple organs and another died of heart failure. Complications included multiple organ infection (1 case) and biliary infection (1 case) and wound infection (1 case).Conclusion Liver retransplantation is an effective treatment for graft failure after liver transplantation. Proper indication and optimum operation time, intensive perioperative supervision and proper treatment were very important for improved effect of liver retransplantation.

Objective To study the clinical effects of postpartum women with vaginal prolapse and bacterial vaginal disease on biofeedback combined with electrical stimulation used in pelvic muscle recover therapy,and explore the effectiveness of the treatment and the positive role, reduce the incidence of pelvic floor functional disease. Methods 157 cases of postpartum women who had detected pelvic floor Ⅰ,Ⅱ muscle fiber strength and vaginal dynamic pressure were selected for the study in our hospital,and divided into the treatment group (82 cases) and the control group group(75 cases).The treatment group were observed on the basis of biofeedback combined with electri-cal stimulation therapy( use of phenix USB4 treatment) .The control group were observed on the basis of Kegel exer-cise.Two groups had treatment of bacterial vaginal disease.Results The treatment group after treatment,total effec-tive rate was 93.90%,better than that of the control group.At the same time Aa point,Ap point and POP-Q was bet-ter,Vaginal prolapse was improved,pelvic floorⅠ,Ⅱmuscle fiber strength and vaginal dynamic pressure was signifi-cantly different compared the control group (χ2 =11.19,P<0.05) .Conclusion The pelvic floor rehabilitation ther-apy can improve the pelvic floor muscle strength of postpartum women,and improve the symptoms of pelvic organ pro-lapse.There was no pain and no damage.The treatment effect is not affected by vaginitis,and which is worthy of clini-cal application.

Objective To explore the feasibility and efficacy of desensitization protocol for highly sensitized renal transplant patients (HSP). Methods Thirty-five HSPs ( HLA class-Ⅰ panel reactive antibody ＞50 %), including 27 patients with a positive T and/or B cell cytotoxicity crossmatch (XM) and 8 patients with a negative T and B cell XM, received plasmapheresis plus intravenous immunoglobulin (PP-IVIG)treatment. Results The positive XM was rendered negative by PP-IVIG treatment in 25 of 27 (92.6 %)HSPs, and subsequent transplantation was performed. Two patients did not receive renal transplants due to persistent positive XM. In 25 patients receiving renal transplants, no hyperacute rejection occurred. There were 8 cases of acute rejection, including 5 cases of acute humoral rejection (AHR). All rejection episodes were reversed. During a follow-up period of 52 ± 26 months, the serum creatinine levels at 12th and 24th month were 112± 18 and 130 ± 38 mol/L respectively. The 1- and 3-year graft survival rate was 96. 0 %and 80. 0 % respectively. Conclusion The desensitization therapy by PP-IVIG is effective for HSP. High rate of AHR is the major defect of this protocol. The short-term graft survival rate after this protocol is acceptable but the long-term survival rate needs to be defined.

Objective To study the molecular mechanism involved in early liver regeneration following cold ischemia after rat orthotopic liver transplantation(OLT). Methods Syngeneic(Lewis to Lewis)rat OLT with hepatic artery reconstruction was performed.Graft survival and liver regeneration following 1 h and 16 h cold ischemic injury were evaluated.Specimen were collected at predetermined intervals from 0,1,2,4,16,24,48,72 h post-reperfusion.The patterns of IL-6 and TNF-α expression,STAT3 activation,and upregulation of immediately early genes(IEGs)including c-fos,c-myc,and c-jun were determined in liver grafts with 1 h and 16 h cold ischemia times.Quantitative analysis of IL-6 at 2 h after reperfusion was performed for grafts preserved for 1 h and 16 h.Progression of hepatocyte replication was confirmed by bromodeoxyuridine(BrdU)immunohistochemistry.Positively BrdU-stained nuclei were quantitated and analyzed between the two groups at 48 h after reperfusion. Results Survival rate in the two groups was 100%.Compared to 1 h cold ischemia group,IL-6 and TNF-α expression and STAT3 activation in 16 h cold ischemia group were markedly increased.Extensive hepatocyte replication was present.Upregulation of immediate early genes of c-fos,c-myc,and c-jun was also observed.Grafts with 1 h ischemic iniury had lower levels of IL-6 than that when grafts suffering from ischemia for 16 h(t=27.7,P＜0.05).Number of positively stained nuclei in 16 h group were more than that in 1 h group at 48 h after transplantation(t=13.4,P＜0.05). Conclusions Severe cold ischemia initiated liver regeneration after rat OLT.TNF-α and IL-6 are important factors in early liver regeneration.IL-6/STA3 pathway in liver regeneration is an important part in the recovery of grafts following cold ischemia injury.

Objective To observe recipient survival time and liver graft regeneration in an orthotopic liver transplantation model using IL-6 knockout mice as a donor.Methods A model of liver transplantation in C57BL/6 WT and IL-6 KO mice with C57BL/6 background was established.Thirty eight mice were divided into three groups:C57BL/6 wild type→C57BL/6 wild type control group(n=10),IL-6 KO→IL-6 KO group(n=14)and IL-6 KO→C57BL/6 WT group(n=14).Hepatocyte replication with BrdU uptake after liver transplantation was examined by immunohistochemistry.Resuits The survival time in the control group was＞16 days.and that was 2 days and 1.6 days in the IL-6 KO→IL-6 KO and IL-6KO→C57BL/6 WT,respectively.The difierence in survival time in all three groups was statistically significant(F=190.09,P＜0.01).The liver grafts in control group showed minimal injury and no necrosis and mild increase of BrdU uptake at 48 hours.Patchy areas of necrosis and hepatocyte ballooning were observed in the two groups using IL-6 KO mice as donors,there was minimum increase in BrdU uptake at 48 hours post transplantation.Conclusion IL-6 KO liver grafts fail to regenerate after liver transplantation.IL-6 is an important factor in liver regerative response.

Objective To explore the effect of kidney transplantation from donation after brain death (DBD) donors with terminal acute renal failure (ARF).Method The clinical data of kidney transplantation from DBD donors with ARF were retrospectively analyzed,and only standard criteria donors (SCD) were included.The results of kidney transplants from ARF donors were compared with those of kidney transplants from DBD donors with normal renal function (serum creatinine ＜ 133μmol/L) performed from January 2012 to March 2014.Result There were 13 donors with ARF and 27 donors with normal renal function (non-ARF donors).The ARF donors had significantly higher terminal serum creatinine than the non-ARF donors (394.9 ± 176.8 vs.75.4 ± 28.6 μmol/L,P＜0.001),but the initial serum creatinine (79.1 ± 17.2 vs.71.0 ± 22.8 μmol/L) and the best creatinine clearance rate (128.3 ± 33.0 vs.129.8 ± 46.8 ml/min) of two groups showed no significant difference (P＞0.05).Twenty-six recipients received kidney transplants from ARF donors (ARF group) and 54recipients received kidney trangplants from donors with normal renal function (non-ARF group).There was no significant difference in the incidence of delayed graft function and acute rejection between ARF and non-ARF kidneys (0 vs.1.9％,and 11.5％ vs.7.4％,respectively).The ARF group had significantly lower estimated glomerular filtration rate (eGFR) at 1st month after transplantation (54.3 ± 16.9 vs.62.5 ± 14.2 mL·min 11.73 m 2,p =0.025),but the eGFRs of two groups were similar at 6th and 12th month after transplantation.During a mean follow-up period of 11.5 months (range 3 to 28 months),actual patient and graft survival rate for both groups were 100％.Conclusion Kidneys from DBD donors with terminal ARF have excellent short-term outcomes and may represent another potential method to safely expand the donor pool.

Objective To study the impact of various donor hepatectomy techniques on clinical rehabilitation and postoperative liver regeneration on living donor liver transplant (LDLT) donors.Methods The data of 13 consecutive LDLT carried out from May 2006 to May 2011,including the surgical techniques,postoperative liver function,and liver regeneration in the donors were retrospectively studied.Results The donor operations included 8 right hepatectomies without the middle hepatic vein,2 right hepatectomies with the middle hepatic vein and 3 left hepatectomies.Hepatic function and blood coagulation function returned to normal within two weeks of hepatectomy in all the donors.There was no severe complication and no death.There was a significant positive correlation between the donor liver volume as measured preoperatively on CT and the resected liver weight as measured intraoperatively (r=0.838,P＜0.01).The volume of the remnant liver increased soon after transplantation.The liver regenerated significantly faster in right than in lefft liver donors.The remnant liver of the right liver donors with middle hepatic vein preservation grew faster than the right liver donors without middle hepatic vein preservation.However,there was no significant difference in the recovery of the liver function between the three groups.Conclusions Donor hepatectomy is safe.The postoperative liver regeneration is affected by multiple factors including the remnant liver volume and blood supply of the remnant liver.

Objective To investigate the effects of ischemic preconditioning on the cholesterol content and the activity of Na+-K+-ATPase of hepatocytes following cold preservation in rats.Methods Twenty-five rats were randomly divided into five groups,including control group (C),cold preservation group (Ⅰ),ischemic preconditioning group (ⅠP),atorvastatin (30 μmol/L) treatment group (A30),and atorvastatin (100 μmol/L) treatment group (A100).The cholesterol content and the activity of Na+ -K+ -ATPase were assessed.Results The cholesterol contents on the rat liver tissue cell membrane in the C group,Ⅰ group,ⅠP group,A30 group and A100 group were (310.4 ± 27.5),(187.7±13.1),(394.3±25.9),(201.8±14.6) and (122.6±7.7) nmol/mg protein,and activity of the Na+ -K+ -ATP enzyme was (46.55 ± 3.20),(27.4 ± 2.81),(52.71 ± 3.02),(30.67 ±2.78) and (19.64 ± 2.11) μmol Pi/hr mg protein,respectively (P＜0.05).There was no significant difference in the plasma membrane phospholipid content among the five groups (P＞0.05).Conclusion Reduction of cholesterol content and Na+ K+ -ATPase activity on the liver cytoplasmic membrane is one of the factors causing donor liver cold preservation injury,but ischemic preconditioning can significantly improve cell membrane Na+ -K+ -ATPase activity and increase cytoplasmic membrane cholesterol content. Use of atorvastatin statins can reduce cytoplasmic membrane cholesterol synthesis,and significantly decrease Na+ -K+ -ATPase activity,thereby alleviating the donor liver cold preservation injury.

Objective To analyze the risk factors for the outcomes of recipients after orthotopic liver transplantation using donation after cardiac death (DCD) donors.Method A retrospective study was performed to observe the available clinical data of 60 patients who had receiced hepatic allografts of DCD donors from July 2007 to December 2012 in our hospital and a 3-year follow-up was conducted to investigate outcome.In the patients whose ALT and/or AST levels were more than 1500 U/L within 72 h following surgery,early allograft dysfunction (EAD) was defined.Potential risk fators right before surgery included donor and recipient age,donor ALT AST,TBIL and WIT,and recipient creatine,TBIL,INR,albumin,MELD,BMI and recipient CIT.Kaplan-meier method was used to calculate the cumulative survival rate.Log-rank test and Cox regression model were performed to analyze donors and recipients related risk factors by univariate and multivariate analysis respectively.All statistical data were analyzed by using SPSS 19.0.Results The overall cumulative survival rate of 1 and 3 years was 76％ and 62％ respectively.Donor ALT,AST and WIT,and recipient Cre,MELD,CIT and EAD were significant risk fators in univariate analysis.However,the multivariate analysis revealed that donor WIT was the only independent risk factor affecting survival in our study.Conclusion By identifying and controlling certain characteristics,the outcomes of DCD liver transplant recipients could be dramaticly improved.