Objective To elucidate the effect of human leukocyte antigen(HLA)cross-reactive groups(CREGs)matching on the patient/graft survival rate of renal transplant recipients positive for penal-reactive antibody(PRA).Methods The PRA level and the HLA antibody specificity of renal transplant candidates were assayed using the LAT1240,LM720R,and SSP2LB kits.The appropriate donors were selected according to the CREGs matching standard.Results 112 recipients included 43 positive cases of HLA classⅠantibody,39 positive cases of HLA classⅡantibody,and 30 positive cases of bothⅠandⅡ.The HLA mismatching cases of 0,1,2,3,4 and 5 allele(s)were 6,39,38, 21,7 and 1,respectively.Hyper-acute rejection(2 cases),acute rejection(18 cases),chronic rejec- tion(5 cases),delayed graft function(4 cases),graft excision(one case)due to rejection and deaths (13 cases,5 with a functioning graft)occurred after transplant.Ninety-nine recipients and 96 grafts survived.The 1-,3-,and 5-year graft survival rate was 91.96%,86.96%,and 86.21%,respec- tively.Conclusion The HLA matching rate of patient/graft was elevated significantly and the effect of high PRA level was decreased according to the principle of CREGs,which increased the patient/graft survival rate remarkably in sensitized recipients.

Objective To investigate ultrasonographic features of primary and metastatic ovarian yolk sac tumors.Methods Ultrasonographic features of 19 primary lesions and 33 metastatic lesions in 35 patients were retrospectively analyzed.Results Primary tumors were sized (14.6±3.6)cm in maximum diameter,manifesting as cysti-solid masses.Solid components of primary tumors were mainly hypoechoic or isoechoic(16/19)with rich blood supplies.Thirty-three metastatic lesions were located in pelvoceliac cavity(26/33) and liver parenchyma(7/33),sized (9.4±4.5)cm,(9.2±4.9)cm and (5.6±1.6)cm in maximum diameter respectively.Metastatic lesions in pelvoceliac lesions mainly demonstrated as hypoechoic masses(21/26), however lesions in the liver were mainly hyperechoic(5/7).Anechoic regions could be found in 9/26 of the pelvoceliac lesions.Blood supply was found less rich in metastatic masses than that in primary ones.Elevated serum level of alpha fetoprotein (AFP) was observed in all patients; ranging from 217 to 211 682 μg/L.Conclusions Primary and metastatic lesions of ovarian yolk sac tumor have obvious ultrasonographic characteristics.Combined with serum AFP level,the accuracy of diagnosis could be improved.

ObjectiveTo evaluate the value of transcranial Doppler (TCD) in pecutaneous transtuminl angioplasty and stenting (PTAS).MethodsThe index of hemodynamics, include mean peak flow velocity (Vm), systolic peak flow velocity (Vs), enddiastolic peak flow velocity (Vd), pulsatility index (Pi), resistance index (Ri) in 47 cases with the stenosis of the middle cerebral artery were investigated, while compared with that of intra arterial digital subtraction angiography (DSA). ResultsVs and Vm of 41 cases increased while the Pi reduced after operation, Ri had no change; Vs, Vm, Vd increased and Pi reduced with no reflow signal in 5 cases. Vs and Vm increased with Vd reduced in only 1 case. The accuracy rate with DSA in moderate or severe stenosis was 75% or 83% respectively. ConclusionTCD, as it's reliable, no-invasive, convenience and cheap, can play an important role in assessing the effect of PTAS in middle cerebral artery stenosis.

objective To explore the role of cytokines and dendritic cells (DCs) in rat high-risk corneal allograft survival pro- longed by superantigen Staphylococcal Enterotoxin B (SEB) and to compare the different effects between SEB and glucocorticoid. Design Experimental study.Participants Fisher 344 and Lewis rats.Methods The Fisher 344 and Lewis inbred rats were used for high-risk penetrating keratoplasty model.All of the Lewis rat recipients were divided into three groups by blinded fashion.GroupⅠand GroupⅡrats were injected intraperitoneally with 0.2ml saline buffer or SEB (75?g/ml) respectively at 4-day intervals on three occasions before transplantation.GroupⅢrats were injected subconjunctivally with 0.1ml dexamethasone (1mg/ml) daily from the first day after surgery for 2 weeks.The allograft survival was examined under slit-lamp.The concentration of interleukin IL-1?,IL-2,IL-4,IL-5,IL-6, IL-10,TNF-?in rat aqueous humor and peripheral blood were measured by liquichip and the cytokine and CD11c,CD80,MHC-Ⅱex- pression in corneal grafts were examined by immunohistochemestry staining.Main Octcome Measures Mean survival time of the allo- grafts,the level of cytokines in aqueous humor,peripheral blood and corneal grafts.Results Compared with group control,the grafts mean survival time was delayed about 3.8d in group SEB (P=0.00) and 7.1d in group dexamethasone(P=0.01).But there was no signifi- cant difference between group SEB and dexamethone (P=0.26).Liquichip test showed that the level of IL-1?in aqueous humor was re- duced and IL-4,IL-6 and IFN-?,ascended.Only IFN-?,and IL-6 could be found in peripheral blood,and the changing shift of them was similar to that in aqueous humor.The immunohistochemistry staining showed that the expression of IL-2 in rat corneal grafts was signif- icantly decreased but IL-4,IL-6 and IL-10 elevated.The expression of DCs in group SEB was similar to that in group control,which was elevated after keratoplasty,but the phenotype of DCs was not the same.There were predominantly mature DCs in group control while immature DCs in group SEB.Conclusions The immunological inhibiting effect of SEB is same to glucocorticoid,but the mecha- nism is different.SEB can modulate immune response,which might induce immune inhibition via the local production of cytokines and effect on DCs maturation involving corneal graft rejection prevention.

Objective To observe the influence of long-term treatment with inhaled corticosteroid on biochemical bone indexes and bone mineral density (BMD) in children with asthma. Methods The design was a randomized, paralleled group study with 3 low dose regiments of 100, 200,300 micrograms of budesonide per day in 45 children with asthma aged 5-8 years old for 12 months. Before inhaled corticosteroid therapy and 6th,12th month,clinical effects were observed and lung function(FEV1) was measured; concentration of serum osteocalcin(OST),insulin-like growth factor-1(IGF-1),bony alkaline phosphatase (BALP) and urinary deoxypyridinolin: creatinine (DPD/Cr) were measured; BMD was examined by dual energy X-ray absorptiometry. Results Clinical evaluation was improved and there was significant increase in FEV1 of asthmatic children. The amount of serum OST was slightly higher,yet no significant compared with that of normal control group. There was significant increase of serum BALP in asthmatic children after treatment; there was significant increase in serum IGF-1 of patients group after treatment compared with in normal children at the same age group; there was significant decrease in urinary DPD/Cr after treatment.There was no significant decrease in BMD before and after treatment at the hip (neck of femur , trochanter of femur ,Ward′s triangle),the lumber area of the spine (L2-4) and forearm (ultradis, distal). Conclusion Long-term treatment with low does corticosteroid dose not restrictedly affect bone metabolism and BMD in children with asthma.

Objective To evaluate the capacity of atopy patch test in diagnosis of food allergy in children with atopic dermatitis (AD).Methods Egg and milk,as the most common food allergens among Chinese children,were employed in this study.Skin prick test (SPT) and atopy patch test (APT) with fresh egg and milk were carried out in 68 children with AD.Oral food challenges in an open style were performed to confirm the diagnosis of food allergy.Resuits Of these patients,58(85.3%)were sensitive to egg,40(58.8%)to milk and 34(50.0%) to both.Of 98 patients with positive challenge,47 showed late response,10 immediate reactions.and 41 mixed reactions.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and the agreement with food challenges in diagnosis of egg/milk allergy were 96.6%/67.5%.90.0%/82.1%,98.2%/84.4%,81.8%/63.9% and 95.6%/73.5%,respectively for APT alone,37.9%/30.0%,100%/89.3%,100%/80.0%,21.7%/47.2% and 47.1%/54.4%,respectively for SPT alone.APT was found to be more sensitive in diagnosis of late-phase reactions than SPT (P<0.01).No significant difference was found in the sensitivity between APT alone and the combination of APT and SPT in parallel algorithm for diagnosis of egg or milk allergy (x2=0.509,0.549,both P>0.05) or in the specificity between APT alone and that in serial algorithm( P=1.000;x2=3.514,P>0.05).Conclusions APT is superior to SPT in diagnosis of late responses to food,and the combination of SPT and APT does not facilitate the diagnosis of food or milk allergy compared with APT alone.

Objective To investigate the clinical value for treatment of diabetic foot with PTA and PTA combined cinepazide maleate.Methods In 24 cases of diabetic associated vascular disease of lower limb,12 cases were treated with PTA and other 12 cases were treated with PTA combined einepazide maleate,We analysed and compared clinical effects before and after the procedure,together with 3 months follow up.Results In patients treated with PTA,the clinical symptom scores of posttreatment and follow-up decreased;ABI and TcPO_2 increased significantly.The clinical symptom score and ABI of follow-up remained,stable,but TcPO_2 decreased significantly.Control angiography showed improvement in degree of vascular stenosis and peripheral staining of 11 patients after treatment.The vascular patency remained in 12 patients and the peripheral staining decreased in 7 patients on follow-up.In patients treated with VIA combined cinepazide maleate,the clinical symptom score,ABI and TcPO_2 after treatment and on follow-up showed no signifcant changes compared with those in patients treated by PTA.F,Control angiography showed that the degree of vascular stenosis and peripheral staining were improved in 12 patients after treatment.The vascular pateney was maintained and peripheral staining was improved on follow-up.Before and after treatment,there were no significant differences in clinical symptom score.ABI and TcPO_2 between patients treated with PTA and PTA combined cinepazide maleate,however,there were significant differences in clinical symptom score and TcPO_2 on follow-up.Conclusion PTA can significantly improve clinical symptom of diabetic foot and the application of cinepazide maleate is a benefitial and necessary supplement.PTA combined cinepazide maleate can be taken as one of the conventional treatment plans for diabetic foot.(J Intervent Radiol,2007,16:811-815)

Background The mechanism of both selenite-induced cataract and age-related cataract is oxidative damage.N-acetylcysteine (NAC) is one of the effective antioxidants,but the literature is little about the preventive and treating effects of NAC on cataract. Objective This study attempted to investigate the preventive and therapeutical effects of NAC on the selenite-induced cataract,and to discuss the possible mechanism. Methods Sixty 10-day-old clean SD rats were randomly divided into normal control group-1,normal control group-2,selenite-induced cataract group,NAC preventive group,NAC+normal saline group and NAC treatment group.Selenite cataract models were induced by subcutaneous injection of 3.46 mg/kg sodium selenite once daily for three days.The rats of NAC preventive group received the intraperitoneal injection of 2 mmol/L NAC 30 minutes before the injection of sodium selenite once daily for 6 days.In NAC treating group,2 mmol/L NAC was intraperitoneally injected 1 day after the injection of sodium selenite for 30 days,and the normal saline solution was injected at the same method in the NAC+normal saline group.Lens opacification was graded according to LOCS Ⅲ criteria.Histopathological change of lens epithelium was examined under a light microscope after hemotoxylin and eosin staining,and the ultrastructure was observed under the scanning electron microscope.The expression of caspase-3 in lens was assayed using immunochemistry.The levels of superoxide dismutase ( SOD ),malonaldehyde ( MDA ) in rat lens were detected respectively in corresponding time points.The use of the experimental animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Committee. Results In 7 days after experiment,lenses were completely clear in the normal control group.Lens opacification of Ⅴ grade was found in 11 eyes in selenite cataract model group,but no lens opacification of Ⅴ grade was seen in NAC preventive group,showing a significant difference(x2 =40.000,P＜0.05 ).In 30 days after experiment,Ⅳ- Ⅴ grades of cataracts were found in 20 eyes both in NAC + normal saline group and NAC treating group (x2=0.153,P＞ 0.05 ).Histopathological examination showed that lens structure was normal,and the separation between LECs and anterior capsule,the rupture of cellular membrane,deformation of cellular nuclei and the feature of lens fiber were seen in selenite cataract group,but the damage of lens was mild in the NAC preventive group.Ultrastructure of lens was obviously abnormal in selenite cataract group,NAC+normal saline group and NAC treating group.Expressions of caspase-3 and SOD in lens were significantly lower,but that of MDA was significantly higher in the selenite cataract group than the normal control group (P＜0.05) ;while those of the NAC preventive group were significantly different from selenite cataract group(P＜0.05).No significant difference was found in the expressions of caspase-3 and the levels of SOD and MDA between NAC+normal saline group and NAC treating group (P＞0.05 ). Conclusions Selenite can induce the apoptosis of LECs.NAC can evidently postpone formation of selenite cataract by increasing the activity of SOD,decreasing the level of MDA and the expression of caspase-3.However,NAC could not reverse selenite-induced lens damage.

Background The construction of tissue-engineered corneal endothelium needs the functional seeding cells,so how to culture a large amount of functional corneal endothelial cells (CECs) is an urgent problem to be solved.Objective The aim of this study was to evaluate the role of aqueous humor on bovine CECs in vitro.Methods Aqueous humor of 1.2 ml was collected from the anterior chamber of bovine and sterilized,and the liquid supernatant was obtained.The bovine CECs were isolated from bovine cornea and then cultured in low glucose Dulbecco Modified Eagle Medium with 10％ fetal bovine serum (FBS) in vitro.Aqueous humor was added into the medium with the final concentration of 2.5％,5.0％,l0.0％,15.0％ and 20.0％,respectively,and no aqueous humor was added in the control group.Cell counting kit-8 (CCK-8) assay was used to detect the absorbency value of CECs for the evaluation of cell proliferation.Progression of the cell cycle was analyzed by flow cytometry (FCM).After confluence of the cells was reached,1 ml plastic spear tip was used to scratch the cell single layer,and the cells were incubated consequently in medium with 10％ FBS and with or without aqueous humor for 24 hours.Healing area of the cell single layer was measured.The cells were incubated at a density of 6 × 105 cells/ml and cultured using medium with or without 10.0％ aqueous human for 5 days,and the number of the cells was analyzed by DAPI fluorescence technique.Results Under the phase-contrast microscopy,the confluent CECs showed a slabstone-like and hexagonal appearance.CCK-8 assay revealed that the absorbance values of CECs was significantly different among the various culture groups (F=4.051,P =0.007),and the absorbance value in different concentrations of aqueous human culture groups was significantly higher than that in the control group (P ＜ 0.01).FCM showed that the percentage of the cells in S-G2 phases was (34.80-±3.13)％ in the 10.0％ aqueous humors group and (23.06±1.13)％ in the control group,showing a significant difference (t =-5.729,P=0.005).The scratch test showed that the healing area of the cell signal layer was (0.116±0.019) mm2 in the 10.0％ aqueous humors group and (0.358 ±0.049) mm2 in the control group,showing a significant difference (t =13.842,P =0.000).The density of cells in the 10.0％ aqueous humor group was (1439± 1 10)/field,which was more than (1162±45)/field in the control group (t =-11.020,P=0.000).Conclusions Aqueous humor at the concentration of 10.0％ promote the growth and proliferation of bovine CECs.The result suggests that 10.0％ aqueous humor can be used as a promoting agent during the culture of CECs.

INTRODUCTION: The aims of this study were to establish weight change, incidence of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk factors (CvRF) in liver transplant recipients (LTRs). METHODS: Eighty-three patients whose mean (standard deviation [SD]) age was 55.6 (8.4) years (median follow-up 73 months) and who underwent their first liver transplantation (LT) at Singapore General Hospital between February 2006 and March 2017 were included in the study. Anthropometric, clinical and demographic data were collected retrospectively from patients' medical records. Diabetes mellitus (DM), hyperlipidaemia and hypertension were regarded as CvRF. RESULTS: Compared to baseline, mean (SD) body weight decreased significantly at 1 month post-LT (60.8kg [11.9] versus 64.3kg [13.7], CONCLUSION CvRF increased significantly post-LT, and NAFLD occurred in 25.3% of LTRs. Body weight dropped drastically within the first month post-LT, which then returned to baseline level just before the end of first year. This novel finding suggests that nutritional intervention needs to be tailored and individualised, based on events and time from transplant. Although long-term obesity is a significant problem, aggressive oral or enteral nutritional supplements take precedence in the early and immediate post-LT period, while interventions targeted at metabolic syndrome become necessary after the first year.
Cardiovascular Diseases/etiology* ; Heart Disease Risk Factors ; Humans ; Liver Transplantation ; Middle Aged ; Retrospective Studies ; Risk Factors ; Singapore/epidemiology*