Objective To investigate the clinical efficacy of methylprednisolone intravenous infusion and to take oral prednisone for patients with pulmonary infection after renal transplantation. Methods One hundred and thirty?six patients with severe pulmonary infection after renal transplantation in our hospital from January 2013 to January 2016 were enrolled and randomly divided into 2 groups. All patients were treated with immunosuppressant adjustment based on the basis of routine treatment. Patients in the observation group were applied methylprednisolone, while patients in the control group were applied prednisone. The clinical efficacy between 2 groups were compared. The changes of body temperature, PaO2 during treatment in survivors of both 2 groups and the changes of ACR, Scr, urine β2?macroglobulin after treatment in survivors of both groups were compared. Results There were 2 cases died and 1 case of renal allograft dysfunction in the observation group. There were 2 cases died and 3 case of renal allograft dysfunction in the observation group. No significant difference in clinical efficacy was found between 2 groups (P > 0.05). For survivors, the recovery time of body temperature in the observation group was significantly shorter than that in the control group. From 16 hours until 4 days after treatment, the body temperature in the observation group was significantly lower than that in the control group (P<0.05), the recovery time of PaO2 in the observation group was significantly shorter than that in the control group. From 2 days until the end of statistics after treatment, PaO2 in the observation group was significantly lower than that in the control group (P<0.05). ACR, Scr, urine β2?macroglobulin were significantly increased in all survivors (P < 0.05). There were no significant differences between 2 groups at every time point (P > 0.05). Conclusion Methylprednisolone can decrease body temperature and increase PaO2 in patients with pulmonary infection after renal transplantation rapidly, with no effects on reducing the mortality and renal allograft dysfunction, and the middle?time renal function.

Objective To analyze the diagnosis and treatment of iliac pseudoaneurysms following renal transplantation.Method The data of two patients with pseudoaneurysm who underwent kidney transplantation were retrospective analysied.Result One case with pseudoaneurysm received transplant nephrectomy,and pathological examination diagnosed mucoraceae infection; the other patient received endovascular treatment and amphotericin B therapy,endly died of hemorrhagic shock.Conclusion The development of pseudoaneurysms at the kidney transplantation recipients with the same donor results in high rates of mucormycosis.They should take anti-fungus therapy and operation as early as possible.

Thirty SHRs were obtained randomly to hypertension, model group, captopril group and Qingre jiangya capsule group. Ten Wistar rats were used as control group. The hippocampus tissue was removed to explore the damage of spontaneously hypertensive rats (SHR) and the protective effect of Qingre jiangya capsule after continuously administered for 14 days. And then the data were processed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The research results revealed captopril group was significantly different from the other three groups. The classification of other three groups is also very clear after captopril group removed. This suggested that Qingre jiangya capsule could improve the overall metabolism compared with captopril. Four metabolites were identified: dimethylglycine, glycerophosphocholine, aldosterone and noradrenaline. Hypertension hippocampus damage may mainly be expressed in tyrosine metabolism, aldosterone-regulated sodium, vascular smooth muscle contraction reabsorption, and Qingre jiangya capsule could reverse the hippocampus tissue damage of SHR.
Animals ; Capsules ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; Hypertension ; drug therapy ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar

Objective To investigate the impacts of low-grade inflammation on the correlation of serum testosterone (T) and carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) men.Methods Based on the concentration of C-reactive protein (CRP) and T,a total of 247 patients was divided into low-grade inflammation with low T group (LI-LT,CRP ≥ 2.0 mg/L,T ＜ 12.0 nmol/L,n =65),low-grade inflammation with normal T group (LI-NT,n =67),non-low-grade inflammation with low T group (NLI-LT,n =56),and non-low-grade inflammation with normal T group (NLI-NT,n =59).General information,medical history,and anthropometry data were collected.Glycosylated hemoglobin AI c (HbA1c),blood fat,and CIMT were detected.Results Compared to NLI-NT group,CIMT in NLI-LT group was increased without statistical significance [(0.87 ±0.09) vs (0.90 ±0.10)mm,t =1.693,P =0.090].CIMT in LI-LT group was increased significantly compared to that of LI-NT group [(0.99 ± 0.10) vs (1.07 ±0.12)mm,t =5.208,P =0.000].Correlation analysis indicated that serum T correlated negatively with CIMT (n =247,r =-0.368,P ＜0.01) in whole.The correlation coefficient of T and CIMT was-0.582 (P =0.000),and-0.098 (P =0.087) in patients with (n =132) and without (n =115) low-grade inflammation,respectively.To make CIMT dependent coefficient and serum T independent coefficient in multiple regression analysis,the partial regression coefficient was-0.062 (95％ CI:-0.094 ～-0.029,P =0.008),and-0.045 (95％ CI:-0.087 ～-0.002,P =0.036),respectively,before and after the adjustment of age,smoking,family history,T2DM course,body mass,blood pressure,HbAlc,and blood fat.After the additional adjustment of CRP,the partial regression coefficient was-0.019 (95％ CI:-0.120 ～ 0.042,P =0.287).Conclusions The negative relationship between serum T and CIMT in T2DM men might be modulated by low-grade inflammation.

Objective To explore the characteristics and effects of interventional therapy of transplant renal artery rupture of donation after citizens death (DCD).Method Among 28 cases of DCD renal transplantations (from February 2012 to December 2013),the transplant renal artery rupture occurred in 4 cases.Vascular complications were treated with the guide wires to place stents in the pseudoaneurysms or bleeding period.Result Pseudoaneurysms occurred in 2 cases,and they were successfully discharged after interventional treatment.In the rest two patients,the artery residual ruptured and bled after the nephrectomy,and they recovered after interventional treatment to stop bleeding.Conclusion For kidney transplant recipients,the DCD postoperative infection is risky.Some transplant kidneys have local infection and erosion of renal artery,which causes arterial hemorrhage.The interventional treatment of transplant renal artery pseudoaneurysms and rupture bleeding has the advantages of small trauma and instant effect,and can be used as an alternative treatment of open surgery.

AIM:To investigate the effects of C1q/TNF related protein 3 (CTRP3) on the insulin sensitivity of insulin resistant 3T3-L1 adipocytes.METHODS: The insulin resistance model of 3T3-L1 adipocytes was induced by palmic acid cultivation.The adipocytes were treated with different concentrations of recombinant CTRP3 protein (10, 50, 250,1 250 μg/L) for 12 h, and for different times (2, 6, 12, 24 h) at the concentration of 250μg/L.The glucose con-sumption was detected by the glucose oxidase method.The glucose transport ratio was measured by 2-deoxidation-[3H]-glucose intake method.The contents of TNF-αand IL-6 in the supernatant were detected by ELISA.The mRNA expression of TNF-α, IL-6 and glucose transporter-4 (GLUT-4) was measured by real-time PCR.The protein expression of GLUT-4 was detected by Western blotting.RESULTS:Compared with normal control ( NC) group, the glucose consumption and glucose intake ratio of insulin resistance ( IR) group was decreased by 50.6%and 57.9%, respectively.Compared with IR group, with the increase in CTRP3 (10, 50, 250,1 250 μg/L) in intervention groups, the glucose consumptions were in-creased by 22.1%, 42.9%, 76.6% and 80.5%, respectively, and the glucose intake ratios were increased by 39.0%, 68.0%, 108.0%and 111.0%, respectively.With the increased duration (2, 6, 12 and 24 h) of CTRP3 treatment at the concentration of 250 μg/L, the glucose intake ratio was increased by 23.0%, 79.0%, 109.0%and 114.0%, respectively. The contents of TNF-αand IL-6 in the supernatant were decreased by 17.4%and 17.1%respectively as treated with CTRP3 at the concentration of 250 μg/L for 12 h, and the mRNA expression of TNF-αand IL-6 was decreased by 26.0% and 18.9%respectively, while the mRNA and protein expression of GLUT-4 was increased by 61.5%and 55.6%respectively. CONCLUSION:CTRP3 may increase the insulin sensitivity of insulin resistant 3T3-L1 adipocytes by down-regulating the expression of inflammatory factors, improving the insulin signal transduction and increasing the expression of GLUT-4.

Currently,the quick development of information technology is enriching the traditional teaching.As a new form of teaching resource,a micro-lecture focused on a specific topic is a good combination of information technology and traditional teaching.It not only increases the vividness and visualization of teaching,but also boosts the learning interest of students in the course.What's more,it helps to show an integral time-consuming experiment in 5-10 minutes'micro-vedio,which broadens the contents of the course and offers convenience of self-teaching for students.In this article,we took the example of micro-lecture"Western blot"in the course of immunologic technology to post-graduates in Shanghai University of Traditional Chinese Medicine to clarify the advantages and the procedures of a typical micro-lecture,and to discuss about it.The experience achieved from the construction of this micro-lecture may offer a new idea of modern information education reform.

This article started from the definition of unavoidable stress injury, analyzed the mechanism of occurrence and the current development of unavoidable pressure injury assessment methods and assessment tools, discussed the limitations of the current differential assessment of unavoidable stress injury, and putted forward relevant suggestions to provide reference for the research on the assessment and prevention strategies of unavoidable pressure injury in China.

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

Objective To explore the feasibility of evaluating cardiac structure, coronary artery,pulmonary artery and cardiac function in one single scan by 320-row CT ECG-gated double phase cardiac function scan mode. MethodsForty patients underwent the 320-detector row CT double phase cardiovascular angiography. The pulmonary phase and aortic phase were reconstructed in order to evaluate the pulmonary and coronary artery. MPR reconstructions of both pulmonary and aortic phase were used to analyze the function of the two ventricles. And the results of the cardiac function were compared with those of transthoracic echocardiography. Thirty-five cases could be analyzed and diagnosed, while the other 5 cases had to be given up because of the poor imaging quality. The mean heart rate was (71.2 ± 11.2) beat per min (bpm). No arrhythmia case included. Results ( 1 ) Pulmonary embolism were diagnosed in 11 cases,coronary artery disease (CAD) were found in 5 cases, while post-stent implantation were observed in 7 cases. Six cases of congenital heart disease were diagnosed with 3 ASD and 3 primary pulmonary hypertension. Another one was diagnosed with left atrial myxoma, and 5 cases were pulmonary embolism associated with CAD. All of above cases were verified by final clinical diagnosis. (2) The heart function parameters including LVEDd , RVEDd, LVESd, RVESd and LVEF were (36.7 ±3.3), (43.3 ± 3.4) mm,(31.6±5.1), (41.3 ±5.1) mm and (47.1 ±15.1) for CT, while those were (40.3 ±3.1), (47.3 ±4.2) mm,(37.3 ±5.6), (45.3 ±3.3) mm,and (46.0 ± 14.8) for ultrasound, respectively. The CT results were correlated with the ultrasound ( n = 35, r = 0.886-0.988, P ＜ 0.01 ). (3) The average radiation exposure was ( 5.4 ± 0.5 ) mSv. Conclusions 320-row CT ECG-gated double phase cardiac function scan mode is feasible for the "one-stop-shop" examination of the cardiovascular disease. This noninvasive method is recommended for the diagnosis, differential diagnosis, treatment and prognosis of cardiovascular disease.