OBJECTIVE To investigate the clinical feature,diagnosis and treatment of tuberculosis in post-solid organ transplantation patients.METHODS The clinical data of 11 patients with tuberculosis post-solid organ transplantation were analyzed retrospectively,in which eight cases were the patients with post-liver transplantation,two cases were the patients with post-kidney transplantation and one patient with post-liver and kidney transplantation.The diaghosis were based on the case history,pathogenic,image and the consequence of diagnostic therapy against tuberculosis were observed.RESULTS Infection rate of tuberculosis after liver transplantation,kidney transplantation and combined liver and kidney transplantation were 0.92%,1.10% and 7.14%,respectively.The three cases suffered from acute miliary tuberculosis.One case suffered from exudative pulmonary tuberculosis.One case suffered from tuberculosis pleuritis.One case suffered from lymph node tuberculosis.One case suffered from tuberculosis of lumber spine complicating exudative pulmonary tuberculosis.Four cases were not found lesion in their body.Each patient was adopted with individual treatment.The following up were 83 day to 1080 day.One case was died.Ten cases were cured.CONCLUSIONS Tuberculosis patients with post-solid organ transplantation had atypical clinical symptom under immunosuppressive agents.Part of the patients are lacked of evidences from image,bacteriology or immunology.Diagnostic errors are made sometimes.Diagnostic therapy against tuberculosis should be put into practice for the patients with suspicious tuberculosis.

AIM:To investigate the influence of pinellia heart-draining Decoction, Licorice heart-draining Decoction, Fresh ginger heart-draining Decoction and its dismantlements on the amount of gastric mucus in rats. METHODS:20 different combination of Banxiaxiexin Decoction and its analogus according to the unform design layout, the amount of gastric mucus in rats was determinated. Stepwise regression analysis was adopted to estimate the relationship between the pharmacological data and compatibility. RESULTS:Rhizoma Coptidis could reduce the amount of gastric mucus remarkbably, the interaction of Rhizoma Pinelliae、Fructus Ziziphi Jujubae and Radix Glycyrrhizae could increase the amount of gastric mucus, and interaction was confirmed among different medicinal ingredients in prescription. CONCLUSION:Uniform design provides a referable exeperimental design for studying analogus decoction compatibility law.

OBJECTIVETo observe the effect of electro-acupuncture (EA) on alteration of immune function of patients undergoing open-heart surgery with cardiopulmonary bypass (CPB), and to appraise the value of acupuncture-drug compound anesthesia in the operation.

METHODSThirty patients undergoing atrial septal defect repairing operation were selected and divided into three groups, Group A was the general anesthesia group; Group B, the acupuncture anesthesia group and Group C, the general anesthesia plus EA group. Peripheral venous blood of patients was collected at different time points, i.e. before anesthesia, before CPB, 30 min and 24 hrs after CPB, to determine natural killer cells activity (NKCA), and the levels of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) in supernatant of cell culture were also tested.

RESULTSNKCA was significantly lowered in Group A before CPB but increased in Group B, while no evident change was found in Group C, so the level of NKCA in Group B was significantly higher than in the other two groups. It lowered in all the three groups after CPB, especially evidently in Group B, so as to cause the NKCA level in Group B lower than that in Group A. The lowering further progressed, 24 hrs after CPB, NKCA in Group B was more reduced than that in Group C. Levels of IFN-gamma and IL-2 lowered in all the three groups after CPB, and further lowered at time point of 24 hrs after CPB, but the parameters in Group C were significantly higher than those in Group B.

CONCLUSIONEA could enhance NKCA, but acupuncture anesthesia couldn't inhibit the suppressive effect of CPB on NKCA, IL-2 and IFN-gamma, suggesting that the immunosuppression induced by stress has a prior effect. General anesthesia plus EA yielded better effect than general anesthesia and acupuncture anesthesia, but it could't improve the immunosuppression completely, indicating that the compound anesthesia could partially improve the immunosuppression induced by CPB.

Acupuncture Analgesia ; Adult ; Anesthesia, General ; Cardiopulmonary Bypass ; Electroacupuncture ; Female ; Heart Septal Defects, Atrial ; immunology ; surgery ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged

OBJECTIVETo compare the clinical effect and complications of subfascial breast augmentation and submammary breast augmentation.

METHODFrom Sept. 2009 to May 2012 , 25 patients with subfascial breast augmentation and 31 patients with submammary breast augmentation were observed. The postoperative results including visible implant edge or ripple, upper pole of the implant and long-term implant ptosis were compared respectively. The complications including hematoma, infection and capsular contraction were also recorded.

RESULTS56 cases were followed up for 2 months to 26 months. The incidence rate of visible implant edge or ripple was 4.0% (1/25 ) in the subfascial group and 29.0% (9/31) in the submammary group, showing a significant difference between them ( PC 0.05). The incidence rate of convex upper pole of the implant was 8.0% (2/25) in the subfascial group and 35.5% (11/31) in the submammary group, showing a significant difference between them ( P < 0.05). Long-term implant ptosis was not found in the two groups. The incidence rate of hematoma was 4.0% (1/25) in the subfascial group and 6.5% (2/31) in the submammary group, infection was not found. The incidence rate of capsular contraction was 8.0% (2/25) in the subfascial group and 12.9% (4/31) in the submammary group, showing no statistical difference between them ( P > 0.05 ).

CONCLUSIONSSubfascial breast augmentation has more clinical advantages compared with submammary breast augmentation, but no evident difference was found in the common complication rate, such as capsular contraction.

Adult ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Middle Aged ; Postoperative Complications ; Treatment Outcome ; Young Adult

Objective: To explore the determinants for health-seeking behavior of the residents after cough for more than 3 weeks in Yiwu, Zhejiang Province, in order to provide reference for prevention and control of respiratory diseases. Methods: A multi-stage cluster random sampling method was used to recruit the community residents aged 5 years and above in Yiwu. A face-to-face questionnaire survey was conducted to collect demographic information, features of cough and health-seeking behaviors in the past month. The multivariate logistic regression model was employed to analyze the associated factors for health-seeking behavior after a cough for more than 3 weeks. Results: Among 6 374 residents investigated, 152 cases had a cough for more than 3 weeks in the past month, accounting for 2.48%. They were( 45.00±21.15 ) years old, including 70 ( 46.05% ) males and 82 ( 53.95% ) females. About 58.55% ( 89 ) of them sought medical treatment. The results of multivariate logistic regression analysis showed that females ( OR=2.100, 95%CI: 1.005-4.391 ), middle school education level ( OR=0.406, 95%CI: 0.168-0.983 ), family annual income of 100 000 to 199 999 yuan ( OR=2.993, 95%CI: 1.215-7.373 ) were associated factors for health-seeking behavior after a cough for more than 3 weeks. Conclusion The rate of health-seeking behavior after a cough for more than 3 weeks among the residents in Yiwu is 58.55%, which is associated with gender, education level and income.

Objective: To investigate the antihypertensive time-effect and dose-effect features of Sancao jiangya decoction(SCD).Methods: The blood pressure of spontaneously hypertensive rats at different time points were measured after treatment with Sancao jiangya decoction of low,middle,high concentration by tailartery blood pressure measurement for conscious rats.Results: The blood pressure was decreased at 2 hours after drug taken,there were significant dose-effect relationship between the antihypertensive effect and the low,middle,high dose.At 4h after drug taken,the high,middle dose had dose-effect correlation,but the low-dose had no antihypertensive effect.Further research on the middledose shows that the blood pressure reduced at 1h after drug taken,and the stable antihypertensive effect was keeping during 1-4h,the blood pressure began to rise at 6h,and got back to the level before drug taken at 8h.Conclusion: To choose the Middle-dose(10.4g crude drug/kg body weight) and 2h after drug taken is appropriate for SCD's use.This result laid a substantial foundation for further research on effects evaluation and mechanism of antihypertensive medicine.

Objectives To reveal etiologies of persistent isolated hematuria (PIH) through ultrastructural pathological examination, to disclose clinicopathological correlation in cases with PIH, and to summarize appropriate management of patients with PIH.
Methods we retrospectively studied 155 PIH patients receiving renal biopsy between January, 2003 and December, 2008 in Peking Union Medical College Hospital. All the clinical data and follow-up result were analyzed.
Results All subjects included 38 children and 117 adults, with mean age of 11.38±3.25 years for children and 35.17±8.44 years for adults. Thin basement membrane nephropathy (TBMN) was the most common pathology (55.3% of children and 49.6% of adults), followed by IgA nephropathy (18.4% of children and 32.5% of adults, mainly grade 2-3) and mesangial proliferative glomerulonephritis (MsPGN) without IgA deposition (13.2%of children and 12.8%of adults). Besides, Alport syndrome (2.6%of children) and membrane nephropathy (2.6%of children and 0.9%of adults) were demonstrated as other causes of PIH. Elevated mean arteral pressure or protein excretion rate, as well as episodic macrohematuria, indicated higher risk for MsPGN rather than TBMN. On the other hand, severity of microhematuria was irrelevant to pathological types of PIH. Totally, 86 patients were followed up and 37 cases therein stayed on track for long term (mean duration 41.11±28.92 months, range 8-113 months). Most cases had benign clinical course except 3 cases with TBMN, 5 cases with IgA nephropathy, 1 case with MsPGN (without IgA deposition), and 1 case with Alport syndrome, who developed hypertension or proteinuria. All of them were administered timely intervention.
Conclusions Close follow-up should be required as the primary management for PIH. Equally important is careful monitoring for early identification of undesirable predictors;while renal biopsy and other timely intervention are warranted if there is hypertension, significant proteinuria or renal impairment.

BACKGROUNDSensitization in transplant candidates increases risk of irreversible immunologic injury of graft in the early period postoperatively. Elimination of anti-human leukocyte antigen (HLA) antibodies using protein A immunoadsorption (IA) might benefit these patients.

METHODSProtein A IA was used in 21 patients with high panel reactive antibody (PRA). The patients had IA 1 - 6 times (median 5 times) with the interval period was 2 - 5 days (median 2.5 days).

RESULTSTotal 67 IA procedures were carried out smoothly in all patients. IA treatment reduced PRA I (pre (31.4 ± 3.8)% vs. post (24.4 ± 3.4)%, P < 0.01) and II (pre (37.1 ± 4.3)% vs. post (34.1 ± 3.9)%, P < 0.01). However, PRA did not change in some patients after the treatment. The serum immunoglobulin (IgG, IgM and IgA) and complement C3, C4 level were decreased significantly. Hemoglobin and albumin levels were slightly decreased associated with IA procedures. Flu-like symptoms were observed in a few of cases during the procedure but generally mild and transient.

CONCLUSIONProtein A IA is capable to efficiently remove serum immunoglobulin and complement, reduce HLA class I and class II PRA in high sensitized transplant candidates, which is likely to benefit the kidney transplantation in these patients.

Adult ; Female ; Humans ; Immunosorbents ; therapeutic use ; Kidney Transplantation ; immunology ; methods ; Male ; Middle Aged ; Staphylococcal Protein A ; therapeutic use

AIMTo develop a sensitive and specific HPLC method for determination of trigonelline in rabbit plasma, and study the pharmacokinetics in rabbit.

METHODSAfter ig of fenugreek extract and i.v. of trigonelline in rabbit, the biological samples could be well purified after precipitation of protein with methanol and acetonitrile. Asahipak NH2P-50 column was used, the mobile phase consisted of acetonitrile-water (90:10) at a flow-rate of 1.2 mL.min-1, and detection wavelength was set at UV 265 nm. The column temperature is 30 degrees C.

RESULTSThe calibration curve was linear in the range from 0.98 mg.L-1 to 31.28 mg.L-1, with r = 0.9986, the detection limit of this method was 50 micrograms.L-1. The concentration-time curves of trigonelline in rabbits after ig and i.v. administration were shown to fit one-compartment and two-compartment open model, respectively. The main parameters after ig of fenugreek extract were as follow: T1/2(Ka) was 0.9 h, T1/2(Ke) was 2.2 h, V was 0.64 L.kg-1, AUC was 1.93 mg.min.L-1. The main parameters after i.v. of trigonelline were as follows: T1/2 alpha was 10.8 min, T1/2 beta was 44.0 min, K21 was 0.044 min-1, K10 was 0.026 min-1, K12 was 0.017 min-1, AUC was 931.0 mg.min.L-1.

CONCLUSIONTrigonelline showed a middle rate of absorption and fast rate of elimination in rabbit. Meanwhile, the method is simple, accurate, with a good reproducibility, and it provide a basic method for the investigation of trigonelline and fenugreek pharmacokinetics.

Alkaloids ; blood ; isolation & purification ; pharmacokinetics ; Animals ; Antineoplastic Agents, Phytogenic ; blood ; isolation & purification ; pharmacokinetics ; Area Under Curve ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; Female ; Male ; Plants, Medicinal ; chemistry ; Rabbits ; Seeds ; chemistry ; Trigonella ; chemistry

OBJECTIVETo investigate the inhibiting action of transforming growth factor-beta type R II receptor(TGF-beta R II) antibody to fibroblasts.

METHODSFour groups of cultured skin fibroblasts were treated with different dosages of TGF-beta R II antibody. Examinations were performed with HYP, MTT, microscope, and flow cytometry techniques.

RESULTSTGF-beta R II antibody resulted in significant inhibition of fibroblasts(P < 0.01).

CONCLUSIONTGF-beta R II antibody has inhibiting effects on the proliferation of skin fibroblasts and with a dose-dependent manner.

Adolescent ; Antibodies, Monoclonal ; pharmacology ; Cell Division ; drug effects ; Cells, Cultured ; Child ; Fibroblasts ; cytology ; drug effects ; ultrastructure ; Flow Cytometry ; Humans ; Microscopy, Electron ; Protein-Serine-Threonine Kinases ; Receptors, Transforming Growth Factor beta ; analysis ; immunology