Objective To study the relationship between the expression of ICAM-1,HLA-DR in the renal allograft of chronic rejection. Methods The expression of ICAM-1 and HLA-DR was assessed in 20 cadaveric renal allografts with chronic rejection using immunohistological techniqu(ABC method). Results In the renal allograft with chronic rejection,the expression of ICAM-1 was increased on the tubular epithelial cells and interstitial microvascullar endothelium,whereas the expression of HLA-DR was up-regulated,especially on the distal tubules. In addition, the expression of ICAM-1 and HLA-DR was associated with lymphcytes infiltration in the local perivascullar and intertubular structure. Conclusions It is suggested that the increased ICAM-1 and HLA-DR expressions might mediate allograft injury and have a role in the augmentation of the response,either in its induction,especially in the interstitial lymphocytes infiltration and antigen presenting or as a target for the effector arm of the reaction.

Objective To observe the protective effect of 11,12-epoxyeicosatrienoic acid(11,12-EET)on immature isolated rabbit hearts.Methods Forty-eight isolated immature rabbit hearts were randomly assigned to two groups: Control group,the hearts were arrested with St.Thomas No.2 solution and stored in the same solution ( n =24);EET group,the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution ( n =24). All rabbit hearts were stored for 8,16 and 24 h with 4 ℃ hypothetmia, and underwent 30 min reperfusion ( 37 ℃ ). On the Langendorff perfusion apparatus,left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+dp/pt max ,coronary blood effluent (CBE) and arrhythmias score were measured before and after ischemia. Myocardial water content,the value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also measured,and myocardial ultrastructure observed. Results Postischemic recovery of myocardial function and myocardial edema were significantly better in EET group at different time points. The changes of arrhythmias score,CK,LDH and myocardial ultrastructure in EET group were superior to those in control group. After the hearts were preserved for 16 h ,the recovery of myocardial function and arrhythmias score in EET group were basically close to the measured values before heart preservation,while those in control group were significantly decreased. After the hearts were stored for 24 h ,all hearts in EET group beated again during reperfusion,but 5 hearts in control group could not beat anymore.Conclusion Addition of 11,12-EET into the St.Thomas No.2 cardioplegic solution could prolong the storage time and enhance the myocardial protective effect to the isolated immature hearts.

Hepatitis virus NAT reagents are now widely used clinically. However, the qulity of domestic and foreign NAT reagents varies dramatically. The main reasons for these differences including the manufacture technique, test principle and assay procedure were discussed in this paper and current status of the quality control of the NAT reagents were also described. Finally, it was pointed out that strengthening public supervision and laboratory internal control are very important for the quality improvement of the domestic reagents.

Objective: To investigate the protective effect of 11,12-EET(11,12-epoxyeicosatrienoic acid)on myocardium of immature rabbit hearts from ischemic reperfusion injury. Methods: 16 isolated immature rabbit hearts were performed to ischemic reperfusion model in a Langendorff perfusion apparatus and randomlyassigned to on two groups. Control group, the hearts were arrested with St.Thomas No.2 solution and stored in the same solution (n=8). EET group, the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution (n=8). These isolated rabbit hearts were stored for 8 hours at 4℃ hypothermia , and underwent 30 minutes of reperfusion (37℃). We measured the preischemia and postreperfusion indexes of left ventricle developed pressure (LVDP), left ventricle end-diastolic pressure (LVEDP), ?dp/pt_ max , myocardial water content (MWC), coronary blood effluent (CBE) and arrhythmia score (AS). The myocardial ultrastructure and value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also observed. Results: (1) After 30 minutes reperfusion, the indexes of CK, LDH, CBE, AS,and the recovery rate of heart function were significantly better in EET group compared with controls. At the same time, no ultrastructural changes were found in the EET group while the capillary endothelial base membrane edema and mitochondrion edema was observed in the control group. (2) In EET group, compared with preischemia, there were no significantly changes of myocardial function at the end of 30-minutes reperfusion. Conclusion: These data suggest that 11,12-EET add to the St.Thomas No.2 solution could offer more little myocardial injury and little arrhythmia and provide better preservation of the isolated immature hearts.

Age-related macular degeneration ( AMD ) is a kind of age-related blinding degenerative fundus lesions, totally about 30 million patients suffering from AMD all over the world, with about 500 000 people blind for it yearly. As the development of economy and the aging of the population intensified, incidence of AMD indicates a trend of rising year by year, being the third major cause of blindness in our country. At present, the pathogenesis of AMD is not fully clear, as reported it may be related to oxidative stress, inflammatory immune response, VEGF and genetic manipulation. Clinical treatments mainly include photodynamic therapy, drug therapy, radiation therapy, laser photocoagulaory operation, the pupil warm treatments, Chinese medicine and intravitreous injection VEGF antagonists such as Ranibizumab, Conbercept and so on. ln this issue, we mainly expound on the progress in the epidemiological studies of AMD, especially elaborate the progress made on genetic manipulation in recent years.

Ewing's sarcoma is a kind of bone and soft tissue tumor which is highly invasive and mainly occurres in children and adolescents.In recent years,combined chemotherapy,surgery and radiation therapy in treatment of Ewing's sarcoma,patients' prognosis and life quality have been significantly improved.However,over the past 20 years,the treatment of Ewing's sarcoma entered the platform period.The 5-year overall survival rate remained at 55％-75％.Multiple metastasis and recurrence are the main factors of poor prognosis and death.Chemotherapy,radiotherapy and molecular targeted therapy are still the main methods for the treatment of Ewing sarcoma.The side effects,drug resistance and the use of the combination regimen of antitumor drugs have been plaguing the clinical workers.In order to improve the efficacy of chemotherapy drugs and reduce the toxic side effects,Multi-disciplinary and multi-center clinical studies on Ewing's sarcoma patients who suffered from local control or recurrence have been launched by Domestic and European and American countries.As an important supplementary mean for the treatment of Ewing's sarcoma,patients often appear a series of complications after radiotherapy,including the risk of local damage or secondary tumors.Therefore,it is necessary to further clarify the indications of radiotherapy and the timing of preoperative and postoperative radiotherapy.The specific chromosome translocation and the expression of the fusion gene EWS/FLI 1 have been found in Ewing sarcoma.Nevertheless,the mechanisms that drive tumor relapse and metastasis remain unknown.Molecular targeted therapy can be used to inhibit tumorigenesis and progression by regulating the upstream or downstream target genes of EWS/ FLI1.In conclusion understanding of the current treatment status of Ewing's sarcoma,results of multi-center clinical trials and theory of genomics research will contribute to the design of new biological therapies so as to establish individualized treatment modalities.In this paper,we present a review on the progress of Ewing sarcoma chemotherapy,radiotherapy,molecular targeted therapy and immunotherapy.

Objective The periacetabular tumor has a low rate of incidence, but its special location poses a challenge to clinical treatment.The aim of this study was to discuss the methods, effects, and complications of surgical treatment of periacetabular tumors. Methods We retrospectively analyzed the clinical data of 36 cases of periacetabular tumor surgically treated in our depart-ment, including 21 males and 15 females, aged 15 to 64 (45.2 ±6.3) years.Among them, there were 8 cases of benign tumor (4 ca-ses of simple bone cyst, 1 case of desmoplastic fibromas, 1 case of osteofibrous dysplasia, and 2 cases of hemangioma) and 28 cases of malignant tumor (5 cases of osteosarcomas, 12 cases of chondrosarcomas, 2 cases of giant cell tumor of the bone, 1 case of malignant chondroblastoma, 2 cases of malignant fibrohistiocytoma, and 5 cases of metastatic tumor of the bone).The benign cases received sim-ple tumor resection plus bone graft and steel plate system internal fixation, while malignant cases underwent reconstruction by combined pedicle screw fixation system with bone cement. Results No patients died perioperatively and controllable complications occurred in 5 cases after operation.All the patients were followed up for 5 to 96 months except for 1 case of benign tumor.None of the benign cases experienced recurrence, and all of them achieved normal hip function.Lung metastases occurred in 10 malignant cases (4 cases of os-teosarcomas and 6 cases of chondrosarcomas) , who died of respiratory failure, and the other 18 remained tumor-free after surgery.Of the 2 patients with malignant fibrohistiocytoma, 1 died 2 years postoperatively and the other survived with tumor.Neither local recur-rence nor lung metastasis was found in the patients with chordoma and malignant chondroblastoma till the end of follow-up.The 5 pa-tients with metastases died within 3 years after operation.At 3 months after surgery, the Harris scores after total hip replacement were >90 in the 7 benign cases, 70-79 in 9 malignant cases, and <70 in the other 19 malignant cases. Conclusion For the treatment of malig-nant tumors, reconstruction by combined pedicle screw fixation system with bone cement does not affect the general daily activities of the pa-tients.Preoperative embolization of the internal iliac artery can reduce bleeding and improve operation safety, and measures should be taken to minimize postoperative complications.

OBJECTIVETo explore the clinical outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF).

METHODSFrom January 2007 to February 2010, the data of 40 patients with osteoporotic vertebral compression fracture underwent treatment were retrospectively analyzed. Of them,20 patients were treated with PVP (PVP group), there were 8 males and 12 females with an average age of (66.37 +/- 2.34) years old (54 to 81); 20 patients were treated with PKP (PKP group), there were 11 males and 9 females with an average of (65.12 +/- 3.21) years old (56 to 79). Postoperative at 1 week, 12 weeks, 1 year, pain and daily life function were respectively assessed by visual analogue scale (VAS) and Barthel index (BI); and anterior height of responsibility vertebra, Cobb angle were measured by X-rays.

RESULTSIn PVP group, 1 case complicated with bone cement leakage without clinical symptoms and no operation to treat. No postoperative infection and deep vein thrombosis were found between two groups. All patients were followed up more than 1 year, pain and daily life function has obviously improved than preoperative (P < 0.01); and there was no significant difference on 1 week, 12 weeks, 1 year after operation (P > 0.05); there was no significant difference between two groups (P > 0.05). In PVP group, there was no significant difference in anterior height of responsibility vertebra, Cobb angle before and after operation;and in PKP group, postoperative data has obviously improved than preoperative (P < 0.01), but there was no significant difference postoperative at 1 week, 12 weeks, 1 year (P > 0.05); there was no significant difference between two groups at 1 week, 12 weeks, 1 year after operation.

CONCLUSIONBoth the methods can obviously relieve pain and completely or partly recover daily life function in treating OVCF. But PKP has advantages of recovery of anterior height of responsibility vertebra and correction of Cobb angle, especially for serious compression.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures ; diagnostic imaging ; physiopathology ; surgery ; Radiography ; Recovery of Function ; Retrospective Studies ; Spinal Fractures ; diagnostic imaging ; physiopathology ; surgery ; Spine ; surgery ; Treatment Outcome

Objective To improve treatment success rate and prognosis for patients with bifrontal contusions by intracranial pressure monitoring.Methods A retrospective analysis was conducted on 79 cases of bifrontal contusions admitted between October 2004 and April 2012.The patients were divided into intracranial pressure monitoring group (n =40) and group without intracranial pressure monitoring (n =39),according to the treatments.Significance of high coronary craniotomy timing,surgical strategy and intracranial pressure monitoring in the diagnosis,treatment and prognosis was analyzed.Results The intracranial pressure monitoring group showed a significantly shorter period concerning osmotic dehydration [(14.24 ± 7.93) days vs (21.61 ± 11.97)days,P＜0.01],ICU stay [(14.38 ±7.56)days vs (24.71-± 17.94)days,P＜0.01] and total hospital stay [(17.20 ±8.09)days vs (33.92 ± 21.70)days,P＜0.01] as well as a better GOS [(4.15 ± 1.22) points vs (3.69 ± 1.56) points,P ＜ 0.05],as compared with group without intracranial pressure monitoring.Conclusions Craniotomy,especially decompressive craniectomy,is one of the most important treatment means to control cranial pressure and ensure cerebral perfusion pressure in patients with bifrontal contusions (in particular the moderate and severe ones).Besides,intracranial pressure monitoring is conducive to selection of surgery timing and is instructive to combined treatment,such as osmotherapy,intracranial pressure controlling and assurance of cerebral perfusion pressure.

Objective To compare the effect of cimetidine associated with bletilla striata,rhubarb on peptic ulcer,cushingulcer,acute erosive gastritis,bleeding of esophagus and gastric funds varicosis of cirrhotic portal hyper- tension and gastri cancer.Methods 136 patients with upper gastrointestinal hemorrhage were randomly divided into 2 groups.The treated group(n=69)was given cimitidine associated with bletilla striata,rhubarb and the control group(n=67)was given cimitidine only.The effects of hemostasis in 2 groups were observed.Results The effect of hemostasis in the treated group was better than that in the control group on peptic ulcer,cushingulcer,acute ero- sive gastritis and gastric cancer(P＜0.05).There were no difference between 2 groups about bleeding of esophagus and gastric funds varicosis of cirrhotic portal hypertension(P＞0.05).Conclusion The effect of hemostasis on up- per gastrointestinal hemorrhage treated by integrated traditional Chinese medicine and western medicine might achieve better on cushingulcer,acute erosive gastritis,peptic ulcer and gastri cancer.It has less adverse effect and more safety.