Objective To analyze the adverse drug reactions(ADRs)of edaravone in treatment of patients with acute cerebral infarction(ACI)by reviewing Chinese medical literature and to evaluate safety of edaravone treatment in ACI.Methods Publications from Pubmed and Chinese Biomedical Literature Datababe(CBMdisc)were reviewed and the ADR of edaravone was analyzed among the published 8645 cases.Literatures about randomed-control clinical trails(RCTs)on security of edaravone for treating ACI Was analyzed by meta-analysis.Results Abnormal hepatic function,especially mild elevation of aminotransferase,renal dysfunction and skin rash induced by edaravone were tIle most common ADRs.Among 8645 patients,ADRs were reported in 283(3.27 % ).The meta-analysis in RCTs showed that between the group treated with a combination of edaravone and routine and the group treated with routine treatment only,there was no significant difference in the occurrence rate of ADRs(OR=1.18,95 % CI0.70-2.00,P=0.536),elevation of aminotransferase(OR=1.23,95 % CI 0.57-2.68,P=0.595)or renal dysfunction including albuminutia,increased level of serum ereatinine and nitrogen(OR=1.65.95 % CI0.57- 4.79.P=0.353).Conclusion Edaravone has a low ADRs OCCurrence rate and iS safely used in cerebral infarction treatment.

BACKGROUND: Adequate preparation of donors and recipients prior to living-related donor renal transplantation, short warm and cold ischemia time for donor kidney, good histocompatibility of human leukocyte antigen match, and low postoperative rejection incidence provide feasibility for use of low-dose immunosuppressive agents after living-related donor renal transplantation. OBJECTIVE: To investigate the safety and effectiveness of low-dose calcineurin inhibitors (CNI), an immunosuppressive agent, in living-related donor renal transplantation. METHODS: A total of 38 recipients who underwent living-related donor renal transplantation at the Center of Renal Transplantation of the First Affiliated Hospital of Nanjing Medical University from January 2006 to June 2008 were randomized for treatment with mycophenolate mofetil (750 mg twice a day), prednisone, and either standard-dose CNI (n=18) or low-dose CNI (n=20) during 12 months post-transplantation. Ciclosporin A was given orally (starting dose, 6 and 4 mg/kg per day, respectively) in two divided doses to achieve the 12-hour whole blood concentration as measured by fluorescence polarization immunoassay. The starting dose of tacrolimus was 0.12 and 0.08 mg/kg per day respectively, and its whole blood concentration was measured by enzyme-multiplied immunoassay technique. After transplantation, patients were followed up. Renal function, pulmonary infection, liver dysfunction, and CNI nephrotoxicity at different time periods were compared between different regimens. RESULTS AND CONCLUSION: During 12 months post-transplantation, patient death occurred in one of 18 patients (5.6%) in the CNI standard-dose group and none of 20 patients (0%) in the CNI low-dose group. There was no significant difference in renal function and acute rejection between CNI standard-dose and CNI low-dose groups (P > 0.05). The incidence of liver dysfunction and CNI nephrotoxicity was significantly lower in the CNI low-dose group than in the CNI standard-dose group (P < 0.05). In addition, a low-dose CNI regimen helped recipients to lessen the economic burdens. These findings indicate that it is effective, safe and economical to use a low-dose CNI regimen in living-related donor renal transplantation.

Objective To explore the quantity change and significance of CD14-/CD11b+/CD33 + myeloid-derived suppressor cells (MDSCs) in patients with multiple injury. Methods Thirtyfour patients with multiple injury and seven healthy volunteers were enrolled in this study. Peripheral blood was collected and the factors of CD14-/CD1 1 b+/ CD33 + were taken as markers of MDSCs. The percentage of MDSCs was determined by flow cytometry (FCM) and serum interleukin-10 and C-reactive protein levels were determined by ELISA to analyze the quantity change and clinical significance of MDSCs. Results The percentage of MDSCs in peripheral blood of healthy volunteers was (1.13 +0. 25) %. At days 1,2, 3 and 7 after injury, the percentage of MDSCs in peripheral blood were (1.20 +0.22) %, (6.44 + 0.35) %, (13.84 ± 2.07) % and (15.60 ± 1.63) % respectively in patients with infection and multiple injury, whereas (1.29 ±0. 30)%, (4.93 +0. 32)%, (5.15 ±0. 21)% and (3.77 ± 0.34) % respectively in patients without infection. The percentages of MDSCs in two groups showed significant differences at days 2, 3 and 7 after trauma (P＜0.05). No correlation was found between MDSCs percentage in peripheral blood and injury severity score, serum interleukin-10 or C reactive protein in patients with multiple injury (P ＞ 0.05). Conclusions The increase of proportion ofMDSCs in peripheral blood correlates with the onset of infection in patients with multiple injury, indicating that the expansion of MDSCs in peripheral blood may play important roles in immune dysfunction after multiple injury.

Objective To analysis and summarise the feature of conventional ultrasound(US) and contrast-enhanced ultrasound(CEUS) of anterior mediastinal tumor.Methods From April 2011 to March 2015,24 patients,diagnosed as anterior mediastinal tumor by chest CT and could be detected by conventional US,were enrolled in this study.Among them,there were 11 lymphomas,5 thymic carcinomas and 8thymomas.The US and CEUS,micro flow imaging(MFI) and time intensity curve(TIC) parameters were evaluated respectively.Results Compare with lymphoma and thymoma in US,there were significant difference between the tumor shape and internal echo respectively (P ＜0.05,P ＜0.05).Compare with lymphoma and thymoma in CEUS,there were significant difference between the display rate of microvascular and feature of enhancement respectively (P ＜ 0.05,P ＜0.05).The result of TIC in different tumors were analyzed respectively.The rise time of lymphoma was early than thymoma,but the half time of wash out of lymphoma was later than thymoma,there was significant difference between the two diseases respectively(P ＜0.05,P =0.01).Further more,the arrive time of invasive thymoma was later than noninvasive thymoma,there was significant difference between the two diseases (P ＜ 0.05).Conclusions CEUS could further assess the characteristic of microvascular perfusion in anterior mediastinal tumors,based on the evaluation of conventional US.It could have a potential clinical value and a development capacity for differentiation diagnosis.

Objective:By analyzing the effect of deacetylase inhibitors on macrophage polarization process of histone modification,and the influence of the process of macrophage polarization ,analysis deacetylase inhibitors whether have the effect on the activity of the macrophage polarization by altered histone modification of macrophages , in order to provide a new perspective for the treatment of autoimmune diseases .Methods:Using lipopolysaccharide ( LPS) and interferon-γ( IFN-γ) to stimulate J774.1 cells for 24 h,and interleukin-4 ( IL-4 ) to stimulate J774.1 cells for 24 h.And 2 mmol/L valproic acid ( VPA ) was added in the induction process.Collecting J774.1 cells,fluorescent quantitation PCR assay and ELISA assay was used for the detection of specific markers of gene expression in macrophage polarization , flow cytometry and immunofluorescence assay for the detection of histone modifications.Results:J774.1 cells were polarized into M1 macrophages which were stimulated by LPS and IFN-γfor 24 h;and also J774.1 cells were polarized into M2 macrophages which were stimulated by IL-4 for 24 h.The degree of acetylation of H 3K9 for M1 phenotype was increased after VPA treatment , the expression of interleukin-6 (IL-6 ) , inducible nitric oxide synthase ( iNOS ) , and chemotactic factor(CCL-2) was decreased,and the expression of CD86 was increased.The degree of acetylation of H3K9 for M1 phenotype was also increased after VPA treatment ,and also the expression of Arginase,Fizz-1,mannose receptor(CD 206) and Ym1 were increased.Conclusion:The polarization state of the macrophages and histone modification had a certain relevance .VPA could induce the transformation of M1 phenotype to M2 phenotype in the induction system of the M1 macrophages,however,the expression of specific genes in M1 phenotype was inhibited in the induction system of the M 2 macrophages.

OBJECTIVE:To develop a method for rapid,accurate and simultaneous determination of dexzopiclone,zolpidam and zaleplon in human plasma. METHODS:After the plasma sample was processed by liquid-liquid extraction,UPLC-MS/MS was established to detect plasma sample with carbamazepine as internal standard. The separation was performed on a Waters ACQUITY UPLC HSS T3 column with mobile phase composed of 0.1% ammonium solution-acetonitrile (gradient elution) at flow rate of 0.2 ml/min. The column temperature was set at 40 ℃,and sample size was 5 μl. The detection was performed by multiple reaction monitoring (MRM) via electrospray ionization (ESI) source in positive mode. The mass transition ion-pairs were as follows:m/z 308.2→263.1(zolpidem),m/z 389.3→245.0(dexzopiclone),m/z 306.2→236.1(zaleplon),m/z 237.3→151.2(internal standard). RE-SULTS:The linear range of zolpidem,dexzopiclone and zaleplon were 0.02-20.00,0.50-20.00,0.02-20.00 ng/ml,respectively (r=0.990 1,0.996 8,0.991 7). LLOQ of them were 0.02,0.50,0.02 ng/ml,and detection limit were 0.01,0.20,0.01 ng/ml. RS-Ds of intra-day and inter-day were all lower than 15% ;extraction recovery were 88.9% -106.5% ;matrix effect were 94.8%-106.3%. CONCLUSIONS:The method is simple,rapid,sensitive and specific,and it can be used for simultaneous deter-mination of zaleplon,zolpidem and dexzopiclone in human plasma.

Objective To investigate the effects of the intracellular delivery of HPV16E7_(49-57) epi- tope modified by cell-penetrating peptide HIV-Tat_(49-57) and its influential factors.Methods The unique HLA-A2+/H-2kb+ limited CTL epitope of HPV16E7 fused with a cell-penetrating sequence (HIV-Tat_(49-57)) was designed and a 18-mer peptide was synthesized with aid of polypeptide solid phase synthesis technique. The intracellular transport capabilities of these peptides were tested with indirect immunofluorescence assay and laser confocal microscopy.In addition,the CTL epitope and 18-met peptide were used to stimulate PBMC of healthy C57BL/6 mice,and the E7_(49-57) specific CTL responses were measured by LDH cytotoxicity detection kit in PBMC of those mice.Results The HIV-Tat_(49-57) peptide could efficiently assist HPV 16E7_(49-57) peptide in penetrating into BHK cells in a time and dose-dependent manner (P＜0.05).Further- more,the specific CTL activity induced by the 18-mer peptide was much stronger than that induced by the single epitope.Conclusion The results show that HIV-Tat_(49-57) can efficiently deliver the exogenous anti- genic peptide into the cytoplasm of live cells,and induce specific CTL response.This is a new way to de- sign peptide-based vaccine of HPV.

OBJECTIVETo express human soluble CD14 (sCD14) in eukaryotic cells.

METHODSHuman sCD14 cDNA was amplified from U937 cells with RT-PCR method. The recombinant expression plasmid pEF1/HisC/sCD14(348aa) was constructed and the expression in COS-7 cells was carried out using liposome transfection method. The yield was examined with scanning map identification. The expressed product was purified by immuno-affinity chromatography.

RESULTSSequence analysis demonstrated that the amplified gene sequence and those reported by documents were completely identical. sCD14 was expressed with high-yield. The expressed product was purified to above 90%. Recombinant sCD14, specifically combinable with endotoxins, had a natural biological activity.

CONCLUSIONSHuman sCD14 was expressed in COS-7 cells, which laid a foundation for further study.

Animals ; COS Cells ; metabolism ; Chromatography, Affinity ; Cloning, Molecular ; Eukaryotic Cells ; metabolism ; Humans ; Lipopolysaccharide Receptors ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; U937 Cells ; metabolism

OBJECTIVETo investigate the relationship between hemostatic changes in liver cirrhosis patients with different degrees of their liver lesions.

METHODSForty-three patients (35 men, 8 women; age: 25 to 71 yr) with liver cirrhosis were divided into three subgroups (A, B, and C) on the basis of Child-Pugh classification. Among the patients, 13 were classified as Child-Pugh class A, 15 were class B, 15 were class C. 16 healthy individuals served as controls. A series of hemostatic tests and parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), factors II, V, VII, VIII, IX, X, vWF assay, antithrombin-III (AT-III), protein C (PC), D-dimer, tissue plasminogen activator antigen (t-PA), plasminogen activator inhibitor activity (PAI) were performed on 43 patients and the 16 healthy controls.

RESULTSPT and APTT were progressively prolonged from A to B and then to C. In comparison to the controls there was a significant difference. Fibrinolytic activity and the activities of factors II, V, VII, IX, X were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference . AT-III and PC activity were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference. D-dimer and t-PA-antigen were progressively increased from A to B and then to C. In comparison to the controls there was significant difference. PAI activity did not display significant changes in the four groups.

CONCLUSIONWe found that there is a close relationship between the severity of cirrhosis and the hemostatic changes. Because the deterioration of the coagulation function and increasing fibrinolytic activity parallel the severity of liver cirrhosis, adequate treatment for cirrhotic bleeding should not only correct the coagulation defects, but also lower the increased fibrinolytic activity.

Adult ; Aged ; Antithrombins ; metabolism ; Blood Coagulation Factors ; metabolism ; Female ; Fibrinogen ; metabolism ; Hemostasis ; Hepatitis B, Chronic ; blood ; complications ; Humans ; Liver Cirrhosis ; blood ; diagnosis ; etiology ; Male ; Middle Aged ; Prothrombin Time ; Severity of Illness Index

Diffuse large B-cell lymphoma (DLBCL) is the most prevalent type of diffuse B-cell lymphoma in non-hodgkin lymphoma (NHL). The progressive enlarging lymphonodus is the most common clinical manifestation of this disease. DLBCL often appears heterogeneous presentations. It is easy to be misdiagnosed. Here, we reviewed a case of DLBCL with liver cirrhosis, in which the initial symptom was upper gastrointestinal hemorrhage, and the endoscopic examination showing gastric ulcer. We hope to improve the understanding and diagnosis and treatment levels of DLBCL by analyzing this case.