Objective To explore the effect of MICA-Ab expression on the prognosis of sensitized renal transplantation recipients.Methods A total of 51 sensitized recipients (PRA more than 20%) in our hospital from August 2007 to April 2010 were enrolled in the study.In these patients,29 cases received protein A immunoadsorption and detection of MICA-Ab was performed before and after protein A immunoadsorption.Other 22 patients received MICA-Ab detection when they were hospitalized.Associations of PRA,HLA-matches,acute rejection,and serum creatinine of postoperative week 1 and week 4 with MICA-Ab were analyzed retrospectively.Results Sixteen recipients (31.4%) had positive MICA-Ab expression but their acute rejection rate was not higher as compared to the patients with negative MICA-Ab expression.Recipients with PRA＞40% showed higher expression level of MICA-Ab than recipients with PRA≤40% (P≤0.05).HLA-match did not show influence on MICA-Ab expression.MICA-Ab positive group had no higher serum creatinine level than negative group in postoperative week 4.MICA-Ab level decreased significantly after protein A immunoadsorption.Conclusions MICA-Ab expression increases in the sensitive recipients but does not influence the prognosis.Protein Aimmunoadsorption can eliminate MICA-Ab effectively in sensitized recipients.

Objective To explore the expression of anti-MICA antibodies and evaluate its influence on acute rejection and renal function in early period after renal transplantation. Methods A total of 29 sensitized subjects (PRA＞20 %) were enrolled in this study. All the patients underwent protein A immunoabsorption treatment and the expression of anti-MICA antibodies was detected before and after treatment. Triple immunosuppressive regimen consisting of tacrolimus, mycophenolate mofetil (MMF) and steroid was given to prevent graft rejection. The correlation between the expression of anti-MICA antibodies and acute rejection or serum creatinine (SCr) level was analyzed.Results The expression of anti-MICA antibodies was detected in 8 candidates (27. 6 % ,8/29) ,and 6 kinds of anti-MICA antibodies simultaneously expressed were found in one individual, 3 kinds in one case,and sole kind in 6 patients. There was no significant difference in acute rejection rate between positive anti-MICA antibodies group and negative group [37.5 % (3/8) vs 38. 1% (8/21), P＞0.05). The positive expression rate of anti-MICA antibodies in the recipients with PRA ≥40% was higher than that in those with PRA ＜40% [43. 8 % (7/16) vs 7. 7 % (1/13),P＜0.05]. The SCr level in patients positive for anti-MICA antibodies was markedly higher than that in those negative anti-MICA antibodies at the 1st week postoperatively ( 135.4 ± 21.4 vs 108. 6 -+ 31.6 μmol/L, P＜0.05). The SCr level in the patients with positive anti-MICA antibodies, however, was reduced to the normal range at the 2nd week after surgery (P＞0.05). The levels of anti-MICA antibodies were continuously decreased in the candidates undergoing protein A irnmunoadsorption treatment. Conclusion Higher expression of anti-MICA antibodies exists in sensitized recipients and possesses an influence on the recovery of renal function in early postoperative period. Protein A immunoadsorption can eliminate anti-MICA antibodies effectively in sensitized recipients.

Objective To study the difference in post-resuscitation lung injury between cardiac arrest induced by anoxia and ventricular fibrillation in porcine model.Methods WuZhiShan inbred miniature pigs were randomly (random number) divided into the asphyxia (AS,n =24) and ventricular fibrillation group (VF,n =24).Cardiac arrest (CA) was induced by endotracheal tube clamping or programmed electric stimulation.Cardiopulmonary resuscitation (CPR) or defibrillation was performed for returning of spontaneous circulation (ROSC).Pulmonary perfusion/ventilation measured with isotope scanand positron emission tomography-computed tomography (PET-CT) scanning were done before and 4hrs after ROSC.The oxygenation index (OI),respiratory index (RI),oxygen delivery (DO2),blood lactic acid,and dynamic pulmonary compliance (Cdyn),airway resistance (Raw),extra-vascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),were measured before cardiac arrest,ROSC 0 h,ROSC15 min,ROSC 30 min,ROSC 1 h,ROSC 2 h,ROSC 4 h and ROSC 6 h.All pigs were sacrificed with euthanasia at ROSC 6 h and the lungs were dissected for observing histopathological changes.The level of Na +-K +-ATPase,Ca2+-ATPase,superoxide dismutase (SOD),Methane Dicarboxylic Aldehyde (MDA),Bcl-2,Bax,Caspase3 and apoptosis index (AI％) in lung were measured.Results The ROSC rate and ROSC 6hrs survival rate of in AS group was lower (P ＜0.01) than those of the VF group.The damages of lung in AS group were more severe than that in VF group by the results of enzymology and protein detection (Na +-K +-ATPase,Ca2 +-ATPase,SOD,MDA,Bax,Bcl-2 and Caspase3).AI％ was higher in AS group (P＜0.01).The deterioration of the indexes (OI,RI,DO2,Lac,Cdyn,Raw,EVLWI,PVPI) at all time points were more severe in AS group than those in VF group.Obvious filling-defect was found by the PET-CT scan of both groups,but not revealed by the isotope scan.Conclusions The lung injury after CA was closely related to the cause of CA rather than the external chest compression.Asphyxia induced more serious lung injury than ventricular fibrillation.

OBJECTIVETo investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.

METHODSFrom June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.

RESULTSAll patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.

CONCLUSIONAnterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Spondylosis ; surgery

OBJECTIVE: To compare the outcomes of endoscopic combined ultrasound-guided access (EUGA) with the conventional ultrasound-guided access (UGA) to achieve percutaneous renal access in endoscopic combined intrarenal surgery (ECIRS). METHODS: A retrospective review of 53 patients undergoing ECIRS to treat upper urinary tract calculi between January 2017 and October 2019 was con-ducted. All of the cases were of complex upper urinary tract stones larger than 2 cm in diameter. The com-plex stone situations, such as multiple renal calyces calculi or staghorn calculi necessitated ECIRS. Under general anesthesia, the patients were placed in the galdakao-modified supine valdivia (GMSV) position, thus allowing both antegrade and retrograde accesss. The patients were divided to UGA and EUGA groups according to the protocol of achieving percutaneous renal access. In 28 cases, endoscopic combined ultrasound-guided accesss were obtained. Puncture and dilation were performed under direct flexible ureteroscopic visualization, while percutaneous renal access of 25 cases were performed with the conventional technique employing ultrasound guidance. Demographic and perioperative information, such as stone burden, presence of hydronephrosis and number of calyces involved was compared. Primary outcomes included total operative time, renal access time, repeat puncture, hemoglobin level, perioperative complications, and stone-free rate. RESULTS: No major intra-operative complication was recorded in all the 53 ECRIS. No significant difference was observed between the groups in age and gender. There was no significant difference in body mass index[BMI (29.21±3.14) kg/m² vs.(28.53±2.56) kg/m²], stone burden (37.68±6.89) mm vs. (35.53±6.52) mm, number of calyces involved 2.72±0.68 vs. 2.86±0.71, presence of hydronephrosis (56.0% vs. 46.4%), total operative time (93.0±12.2) min vs. (96.8±14.2) min, hemoglobin level reduction (6.56±2.16) g/L vs. 97.54±2.64) g/L, stone-free rate (92.0% vs. 92.8%), hospital stay (5.52±0.59) d vs. (5.64±0.62) d, perioperative complication rate (8.0% vs. 7.2%). Two patients in EUGA group experienced perioperative complications (one urinary tract infection and one hematuria) while two patients in UGA group experienced perioperative urinary tract infection. None in both groups received blood transfusion. The patients undergoing EUGA had shorter renal access time [(4.0±0.7) min vs. (6.8±2.6) min, P < 0.01] and less repeat puncture (0 vs. 4 cases, P < 0.05). CONCLUSION EUGA is an optimal technique to establish percutaneous renal access in ECIRS, which minimizes access time and repeated procedures.
Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Ultrasonography, Interventional ; Ureteroscopy

Objective To research the jugular foramen,internal auditory pore (IAP)and the turning point between its components by imageological methods and to provide theoretical basis for retrosigmoid approach in the operation of acoustic neurinoma.Methods The skulls of 100 volunteers were scanned to get the final result with thin-section computed tomographic image. High-resolution spiral CT multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane to measure the distance between the turning point of retrosigmoid (A),the edge of jugular foramen(B)and the lower edge of the internal auditory canal(C)(denoted AC,AB,BC) and the shortest distance from the jugular foramen to AC.The angles between AC,AB and sagittal axis(α,β) were measured.Results The distance of AC was (44.94 ± 3.84)mm,the distance of AB was (43.68 ± 4.56)mm.The distance of BC was (6.15 ±2.04)mm,and the shortest distance between jugular foramen and AC was (5.21±0.23)mm.The angleαwas measured as (39.50±4.74)°,and the angleβwas measured as (46.35± 5.51)°.Conclusion The research measure the distance and angle between entry points and landmarks of retrosigmoid approach and the safe distance.

Objective To investigate the effect of silencing E6-associated protein(E6AP)on the level of p53 protein in human papilloma virus(HPV)negative cervical cancer cells(C33A cells).Methods The siRNA sequence silencing E6AP(siE6AP)and silencing control disordered siRNA sequence(siControl)were transfected into C33A cells with the mediation of LipofectamineTM2000 transfection reagent respectively.The silencing effect of siRNA on E6AP and the expression of p53and cleaved-caspase-3 proteins were detected by Western blot.Results The levels of E6AP protein in C33A cells of siE6AP group were significantly lower(t =-4.597,P<0.05),while the levels of p53 and cleaved-caspase-3 proteins were significantly higher than those of siControl group(t = 4.533 and 7.099 respectively,each P<0.05).Conclusion Silencing of E6AP significantly increased the expression of p53 protein in C33A cells,indicating that silencing of E6AP may restore the activity and function of p53 protein in C33A cells.

It has gradually become a consensus in the industry that the traditional Chinese medicine gypsum should be decocted first, but the understanding of decocting method is not completely unified in the works of doctors since ancient times, and there are occasional disputes about whether it is necessary to decocting first. In this study, the phase determination, physical and chemical characterization, qualitative and quantitative analysis of inorganic and organic components of the decoctions of herbal pairs and the whole prescription Maxingshigan decoction with gypsum as the center, and the pre-decoctions and co-decoctions of them were carried out to explore the scientific connotation of the pre-decoctions of gypsum. Results show that decoction phases were different between the co-decoctions and pre-decoctions of licorice-gypsum (Gancao-Shigao, GC-SG), ephedra-gypsum (Mahuang-Shigao, MH-SG) and almond-gypsum (Xingren-Shigao, XR-SG). The results of the micromorphology, particle size and zeta potential of herbal pairs and prescription (Quanfang, QF) showed that the supramolecular particles in pre-decoctions were smaller, more uniform and more stable than the co-decoctions. The results of organic components analysis showed that different cooking methods did not change the organic composition and content. ICP-OES results showed that the content of inorganic components in pre-decoctions was higher than in co-decoctions for the same boiling time of gypsum. The IR results showed that the pre-decoctions had stronger chemical functional group effect than the co-decoctions. To sum up, compared with the co-decoction, the pre-decoction of gypsum has different phase state and chemical composition interaction, and the difference of inorganic composition is an important material basis affecting the change of phase state compared with the co-decoction. It indicates that the material basis of traditional Chinese medicine decoction is indeed different whether gypsum is decocted first or not, which can provide a basis for the clinical application of decocted gypsum.

BACKGROUNDMorbidity and mortality after resuscitation largely depend on the recovery of brain function. Ventricular fibrillation cardiac arrest (VFCA) and asphyxial cardiac arrest (ACA) are the two most prevalent causes of sudden cardiac death. Up to now, most studies have focused on VFCA. However, results from the two models have been largely variable. So, it is necessary to characterize the features of postresuscitation cerebral metabolism of both models.

METHODSForty-four Wuzhishan miniature inbred pigs were randomly divided into three groups: 18 for VFCA group, ACA group, respectively, and other 8 for sham-operated group (SHAM). VFCA was induced by programmed electric stimulation, and ACA was induced by endotracheal tube clamping. After 8 min without treatment, standard cardiopulmonary resuscitation (CPR) was initiated. Following neurological deficit scores (NDS) were evaluated at 24 h after achievement of spontaneous circulation, cerebral metabolism showed as the maximum standardized uptake value (SUVmax) was measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. Levels of serum markers of brain injury, neuron specific enolase (NSE), and S100β were quantified with an enzyme-linked immunosorbent assay.

RESULTSCompared with VFCA group, fewer ACA animals achieved restoration of spontaneous circulation (61.1% vs. 94.4%, P < 0.01) and survived 24-h after resuscitation (38.9% vs. 77.8%, P < 0.01) with worse neurological outcome (NDS: 244.3 ± 15.3 vs. 168.8 ± 9.71, P < 0.01). The CPR duration of ACA group was longer than that of VFCA group (8.1 ± 1.2 min vs. 4.5 ± 1.1 min, P < 0.01). Cerebral energy metabolism showed as SUVmax in ACA was lower than in VFCA (P < 0.05 or P < 0.01). Higher serum biomarkers of brain damage (NSE, S100β) were found in ACA than VFCA after resuscitation (P < 0.01).

CONCLUSIONSCompared with VFCA, ACA causes more severe cerebral metabolism injuries with less successful resuscitation and worse neurological outcome.

Animals ; Asphyxia ; complications ; physiopathology ; Brain ; metabolism ; Cardiopulmonary Resuscitation ; Heart Arrest ; metabolism ; pathology ; therapy ; Positron-Emission Tomography ; Swine ; Ventricular Fibrillation ; metabolism ; pathology ; therapy

OBJECTIVETo further study the binding character of hepatitis B surface antigen (HBsAg) and beta 2-glycoprotein I (beta2GP I) and to explore whether beta2GP I plays an important role in the hepatotropism of hepatitis B virus.

METHODSUsing Western blot technique, we observed the binding character of the HBsAg with reduced and non-reduced beta2GP I.

RESULTSrHBsAgs with reduced and non-reduced beta2GP I showed identical binding activity.

CONCLUSIONSThe binding activity of HBsAg is dependent on tandem residues, but not on conformational structures of beta2GP I. There is a specific binding between HBV and beta2GP I, which may play an important role in HBV infection and is one of the reasons of hepatotropism of HBV.

Hepatitis B ; virology ; Hepatitis B Surface Antigens ; metabolism ; Hepatitis B virus ; pathogenicity ; Humans ; Viral Envelope Proteins ; blood ; beta 2-Glycoprotein I ; blood