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 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 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 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 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 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 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 evaluate the effect of endoscopic retrograde cholangiopancreatography (ERCP) in treatment of biliary complications after liver transplantation. Methods Data of 39 patients who underwent ERCP between January 2005 and December 2007 because of biliary complications after liver trans-plantation were retrospectively evaluated. Endoscopic sphincterotomy, dilatation, nasal-biliary drainage (ENBD) and stent placement were performed in 25 patients with biliary strictures (14 at anastomosis site and 11 at non-anastomosis site). ENBD and stent placement were applied in 6 patients with biliary leakage, while endoscopic sphincterotomy, ENBD and stone extraction with baskets were performed in 16 patients with biliary stones. Procedures were repeated when necessary. Results ERCP was successfully performed at a rate of 95.9% (94/98) without any severe complications. Strictures at anastomosis site were resolved in all patients (100%, 14/14), while for strictures at non-anastomosis site, only 27.3% (3/11) were cured. Biliary leakage was resolved in 83.3% (5/6) patients. Complete bile duet clearance was achieved in 81.3% (13/16) of the patients with biliary stones. Conclusion ERCP proves to be safe and effective in the treatment of post liver transplantation biliary complications with low incidence of severe complications.

Objective To establish a model of multiple organ dysfunction syndrome in the elderly (MODSE) by intraperitoneal injection of different doses of zymosan, and to compare the multiple organ dysfunction syndrome (MODS) in adult and in the elderly rats. Methods Adult and senile rats, injected with different doses of zymosan intraperitoneally were examined for the changes in the function and morphology of the vital organs, including heart, liver, brain, lungs, and kidneys using blood gas and biochemistry analysis and histopathological examination methods. Results Compared with the normal controls of the adult and the elderly rats, the blood gas and blood biochemistry changed in different degrees in the different dosed zymosan groups. Pathological changes were also found in the vital organs including lungs, heart, liver, brain, kidneys, erc in the experimental groups. Under the same concentrations of zymosan, the reductions in respiratory, cardiac and renal functions in the senile groups were much more severe than those in the corresponding adult group. In the similar degree of model duplication, the senile rats had the tendency to die later than the adult rats. Conclusions Zymosan can be used in both elderly and adult rats to induce MODS model, and the best dosage for MODSE was 0.Sg/kg injected peritoneally. The model would hopefully be used in the study of mechanisms and the therapeutics on MODSE.

BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria.