Objective To evaluate the efficacy and safety of using basiliximab in place of a corticosteroid for immunosuppression following liver transplantation for hepatocellular carcinoma (HCC) in Chinese patients.Method The records of 178 patients with HCC who underwent orthotopic liver transplantation from January 2003 to December 2009 were retrospectively reviewed.All patients received immunosuppression therapy that contained either basiliximab (n =78) or steroids (n =100) in addition to tacrolimus and mycophenolate mofetil.Assessments included complications related to liver transplantation,occurrence of steroid side effects,recurrence of HCC,and patient and graft survival.Results A smaller proportion of patients receiving basiliximab than steroids experienced de novo diabetes (38.7％ vs.91.0％,respectively) or long-term de novo diabetes mellitus (4.0％ vs.30.3％,respectively) (both,P＜0.0001).The median overall and disease free survival was similar between basiliximab (50.8 months and 19.6 months,respectively) and steroid treated patients (64.2 months and 23.8 months,respectively).The 5-year overall survival and disease free survival rate was also similar between the basiliximab (42.5％ and 38.9％,respectively) and steroid (50.5％ and 39.2％) groups (all,P＞0.730).However,in patients who met the Milan criteria basiliximab was associated with greater 5 year overall survival rate than steroid therapy (88.9％ vs.57.4％,respectively,P =0.022).Conclusion It revealed that the non-steroid treatment does not increase the incidence of acute rejection but also can decrease the incidence of de novo diabetes in the patients with HCC following liver transplantation and prolong the survival time of patients who met the Milan criteria.

Objective To study the correlation between single nucleotide polymorphisms of -238,-308 G/A in promoter region of tumor necrosis factor -?(TNF-?) gene and the type of juvenile idiopathic arthritis (JIA).Methods Clinical data and blood preparation of 127 children with JIA and 106 healthy children were evaluated.Subgroups of JIA were defined according to the Edmonton criteria.The -238 G/A and -308 G/A polymorphisms in DNA analysis in this study were extracted from the whole blood.The restricted fragment length polymorphisms were determined in the cases of all JIA children and control group.Results 1.The TNF-?-238 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 92.9% and 7.1%,and the control group was 95.3% and 4.7%.The distribution of allele frequencies was no significantly different between JIA group and control group(?2=1.149 P=0.284).But there were significant difference between polyarticular JIA (RF negative) and control group(?2=7.621 P=0.006).2.The TNF-?-308 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 94.1% and 5.9%,the control group was 95.3% and 4.7%.The distributions of allele frequencies was no significantly different between JIA group and control group(?2=0.322 P=0.571).There were significantly difference between polyarticular JIA (RF negative) and control group (?2=7.621 P=0.006).Conclusions The TNF-?-238,-308 polymorphisms of A in the-238 and-308 TNF-? gene are important to the joint destruction of JIA.The study will be beneficial to provide indirect support to the application of anti-TNF drugs to the treatment of JIA.

24. Of 6 patients positive in SDS, 4 cases scored 56 as moderate depression. Mean score was 47.62 for SDS, and 20.31 for HAM before treatment, and 32.23 for SDS, and 8.97 for HAM after 5 weeks of treatment. The differences were statistically significant (P

Objective To evaluate the clinical diagnostic value of nucleic acid amplification (TB- RNA),bacteriophage-based assay,3D culture and smear on the detection of Mycobacteria tuberculosis.Methods 291 clinical sample including 110 sputum,54 thoracic fluid,37 throat swab,31 bronchial fluid,13 cerebrospinal fluid,12 urine,8 lymph fluid and 20 others (pericardial effusion,feces, blood and abdominal fluid) and gynecological specimen (including 6 leucorrhoea and menstrual blood) were analyzed by these four methods.Results Among the 291 clinical samples,the positive rate of mycobacteria tuberculosis for TB-RNA,bacteriophage-based assay,3D culture and smear were 37.1%,28.9%,27.5% and 10.3%.The sensitivity and specificity of the TB-RNA,bacteriophage-based assay,3D culture and smear were 54.3% & 100%,41.7% & 88.9%,31.7% & 93.5% and 14.6% & 98.9%,respectively.Conclusions TB-RNA is an effective clinical diagnostic method for Mycobacteria tuberculosis.Although the sensitivity of smear is poorer than others,it is a universal testing method in clinical laboratory due to low cost.The positive rate of mycobacteria tuberculosis for 3D culture is lower than that of bacteriophage-based assay and TB-RNA.Although the time to result for 3D culture might last for few weeks,the isolates can be used for drug resistance screening and bacterial identification.

Objective To investigate the efficacy of spectral entropy measurement in reflection of depth of anesthesia and noxious stimulation. Methods Forty-five patients of ASAⅠorⅡ were randomly divided into three groups(n=15).Group A,B and C received fentanyl 1,3 and 5 ?g/kg,respectively,3 min before target controlled infusion(TCI) of propofol.Intubation was performed when the effect-site concentration(CE)reached 3.5 ?g/mL,which was maintained until 5 min after incision.Response entropy(RE),State entropy(SE) as well as heart rate(HR),mean arterial pressure(MAP) were measured at the time points of before fentanyl and 2,3 min after fentanyl,every CE of propofol steps,before intubation,immediately and 1,3,5 min after intubation,before skin incision,and 0.5,1,3,5 min after skin incision,respectively. Results Three minutes after receiving fentanyl,the values of RE and SE in the three groups decreased significantly in a dose-dependent manner,and increased obviously at the same degree during intubation and after skin incision.The values recovered to the level before stress stimulation 1 min after intubation and 5 min after skin incision.There were no differences in the fluctuation of RE and SE among the three groups when the CE of propofol reached 1.0 ?g/mL.Conclusion Spectral entropy may effectively reflect the depth of anesthesia,but not analgesia during anesthesia.

Objective To discuss the role of assistance of intraoperative uitrasonography in ret-roperitoneal laparoscopic nephron-sparing surgery for renal tumors. Methods The intraoperative laparoscopic ultrasonography was applied in retroperitoneal nephron-sparing surgery for 20 patients, of whom 11 were men and 9 were women. The average age was 53(range 33 to 73) years. There were 12 patients with renal cell carcinoma and the mean tumor size was 2.9(range 1.4 to 4.6)cm in diame-ter. All of them were staged as T1 N0 M0. Seven patients had angiomyolipoma and the mean tumor size was 4.5(range 1.8 to 8.0)cm in diameter and 1 patient had a 3.1 cm oncocytoma in diameter. The ul-trasonography was used to locate the tumor, observe the bloodstream and detect whether there were small satellite tumors. The surgical time, time of renal artery occlusion and operative effect were ob-served. Results Laparoscopic surgery was successful in all cases without conversion to open surger-y. Mean operative time was 115 (range 85 to 270) min, mean time of renal artery occlusion was 28 (range 22 to 50) min. During the mean followup of 16(range 4 to 30) months, no patients with renal cell carcinoma had local or port site recurrence or metastatic disease. Conclusion In retroperitoneal laparoscopic nephron-sparing surgery, the intraoperative uhrasonography is helpful to locate the tumor in the surgery, to estimate whether the renal artery is occluded completely and to excise the tumor pre-cisely.

ObjectiveTo compare orthotopic liver transplantation (OLT)and combined liverkidney transplantation (CLKT) in the treatment of severe hepatitis B.MethodsIn this study 52 patients of severe hepatitis B were allocated to OLT (40 cases) or CLKT( 12 cases) at our department from Jan.2001 to Sep.2005.The perioperative complications and the result of follow-up were analyzed.ResultsThe preoperative renal functions in CLKT cases were severer than that in OLT cases.Postoperative severe infection was more common in CLKT cases than that in OLT cases.In OLT group 28 patients (70％)suffered from early posttransplant renal dysfunction,among them 11 patients needed dialysis,whilst there were 2 (16.7％ ) patients who needed dialysis in CLKT group (P ＜0.01 ).The posttransplant mortality in OLT group was 40％ ( n =16),significantly higher than that in CLKT ( 16.7％,n =2) ( P ＜ 0.01 ).In OLT group,9 cases developed severe renal failure and died.No one died of renal failure in CLKT group.ConclusionsThe prognosis is more favorable to perform CLKT in patients who suffered from severe hepatitis B with chronic renal dysfunction before transplantation.

Objective:To investigate roles of autophagy in ameliorating sepsis-induced acute lung injury by allicinin in mice.Methods:A total of 152 male Balb/c mice (8-week old) were randomly divided into a sham group,a septic model group,an allicin treatment group,and an autophagy inhibition group.Septic mouse model was established by cecal ligation and puncture (CLP).Mice in the allicin treatment group were given allicin (30 mg/kg,intra-peritoneal injection) at 6 and 12 h,while those in the autophagy inhibition group were given autophagy inhibitor 3-MA (15 mg/kg,intra-peritoneal injection) at half an hour after allicin administration.Mice in the model and sham group were administered with the same amount of saline.Twenty mice in each group were randomly chosen to observe the 7 d survival rate.The other 12 mice were killed at 24 h,and the bronchoalveolar lavage fluid (BALF) (n=6) and lung tissues (n=6) were collected.ELISA was used to detect the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the BALF.Hematoxylin-eosin staining was preformed to show the morphological changes in the lung tissues.Malondialdehyde (MDA) content and the activity of superoxide dismutase (SOD) in the lung tissues were examined.The expression of LC3B and Beclin-1 was determined by immunohistochemical analysis.Results:Compared with the sham group,the 7 d survival rate and lung SOD activity were decreased in the CLP group (P<0.05);the lung morphological damage score,the levels of TNF-α and IL-6 in the BALF,MDA content in the lung,and expression of LC3B and Beclin-1 were increased greatly in the CLP group (P<0.05).Compared with the CLP group,the 7 d survival rate,lung SOD activity and the expressions of LC3B and Beclin-1 were increased significantly in the allicin treatment group (P<0.05);the lung morphological damage scores,the levels of TNF-α and IL-6 in the BALF and MDA content in the lung were decreased obviously in the allicin treatment group (P<0.05).Compared with the allicin treatment group,the 7 d survival rate,lung SOD activity,and the expressions of LC3B and Beclin-1 were decreased in the 3-MA group (P<0.05);the lung morphological damage scores,the levels of TNF-α and IL-6 in the BALF,and MDA content in the lung were increased significantly in the 3-MA group (P<0.05).Conclusion:Allicin may ameliorate sepsis-induced acute lung injury in mice by enhancing the level of autophagy.

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult

AIM: To observe the changes of cardiomyocytes after stimulation by TNF-?, IL-1?, LPS.METHODS: Cardiac ventricular myocytes were cultured in vitro. Different doses of TNF-?, IL-1?, LPS were added to stimulate the cardiomyocytes, the hypertrophy of cardiomyocytes 8 h, 24 h, and 48 h after stimulation was determined and the apoptosis were also observed 24 h, 48 h, 72 h after stimulation. RESULTS: Compared to the normal myocytes, the cardiomyocytes were hypertrophied after stimulation by 10 ?g/L, 15 ?g/L of TNF-?, 20 ?g/L, 100 ?g/L of IL-1? and 10 mg/L, 15 mg/L, 20 mg/L of LPS, and the effect was dose-dependent, the strongest effect was showed in 24 h. Moreover, 20 ?g/L of TNF-?, 100 ?g/L of IL-1? and 30 mg/L of LPS caused cardiomyocyte apoptosis, especially in 72h. CONCLUSION: TNF-?, IL-1?, LPS induced the cardiomyocyte hypertrophy and apoptosis, suggesting the inflammation may be the main cause of cardiovascular disease.