Objective To investigate the effect of C4d deposition in peritubular capillary (PTC)in chronic allograft nephropathy (CAN) on prognosis and intervention of renal transplantation recipients. Methods All the cases who received the renal graft biopsy due to diagnosis of CAN from January 2000 to August 2008, and had the 2-year follow-up data were included in the study. The clinical data were analyzed according to the C4d deposition in PTC. Results Among 86 cases 39 cases were C4d positive (C4d+ group) and the remaining 47 cases were negative (C4d group). There was no significant difference in sex, age, donor source, transplant times, time after biopsy, the panel reactive antibodies (PRA) level between two groups (P＞0. 05). Before intervention, there was no significant difference in serum creatinine (Scr) and 24 h urinary protein between two groups (P＞0. 05). At the end of 2-year followed-up period, graft loss rate and urinary protein levels in C4d+group were significantly higher than in C4d- group (P＜0. 05). Before intervention, the incidence of blood lipid disorder and hypertension was higher in C4d- group (P ＜ 0. 05 ), but no significant difference was found in uric acid and blood sugar levels (P＞0. 05). At the end of 2-year followed-up period, there was no significant difference in blood glucose, uric acid, blood pressure and lipid profile (eliminating renal lost cases) between two groups (P＞0. 05). Conclusion The patients with CAN and C4d+ means the involvement of chronic humoral rejection and have poor clinical results. Effective intervention against humoral immune response can improve renal allograft survival.

Objective To study the effects of acupuncture combined with Anchang powder acupoint application in the treatment of irritable bowel syndrome with diarrhea. Methods A total of 100 patients with irritable bowel syndrome with diarrhea in our hospital from July 2014 to July 2016 were enrolled.The subjects were randomly divided into the control group (n=50) and the treatment group (n=50). The control group were treated with trimebutine, while the treatment group were treated with acupuncture combined with Anchang powder acupoint application. The two groups were treated for 4 weeks. The clinical effects of the two groups after treatment were compared. The clinical symptom scale was used to evaluate the clinical symptoms, and the quality of life was evaluated by the quality of life scale (QOL) The recurrence rate after half a year heal of the two groups were compared. Results The total efficacy rate of the treatment group was 92.0% (46/50), significantly higher than 68.0% (34/50) of the control group (x2=9.000, P=0.003). After treatment, the clinical symptom integral(1.89 ± 0.95 vs.4.02 ± 1.13,t=10.202)of the treatment group were significantly lower than the control group(P<0.05).After treatment,the quality of life rating scores(34.15 ± 6.75 vs.28.47 ± 5.01,t=4.803) of the treatment group were significantly higher than the control group (P<0.01). Half a year after treatment, the recurrence rate of the treatment group was 24.1% (7/29), significantly lower than 64.7% (11/17) of the control group (x2=7.405, P=0.007). There was no significant difference of the two groups during the treatment. Conclusions Acupuncture combined with Anchang powder acupoint application showed a good efficacy for the patients with irritable bowel syndrome with diarrhea. And the treatment showed the low incidence of adverse reactions and low recurrence rate, can mprove the clinical symptom and quality of life.

OBJECTIVETo evaluate the feasibility of combined high dose leucovorin plus 5-fluorouracil infusion for head-neck and digestive tract cancers.

METHODSFifty-six patients with head-neck and digestive tract cancer were treated by combined high dose leucovorin (HD-CF) plus 5-fluorouracil (5-Fu) 48 hour continuous infusion with each patient receiving an average of 3.8 cycles (2-6 cycles). Twenty-five of these 56 patients were untreated and 31 recurrent. Their clinical stages were II 4, III 13 and IV 39.

RESULTSThe over all response rate (CR + PR) was 35.7% and the clinical beneficial response rate was 80.4%. The main side effects were peripheral phlebitis, suppression of bone marrow, oral ulcer, nausea and vomiting of grade I to II.

CONCLUSIONHigh dose leucovorin plus 5-fluorouracil 48 hour continuous infusion is useful with favorable cost/utility ratio for head-neck and digestive tract cancer patients. Further studies are warranted.

Adult ; Aged ; Aged, 80 and over ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Digestive System Neoplasms ; drug therapy ; Drug Therapy, Combination ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; therapeutic use ; Head and Neck Neoplasms ; drug therapy ; Humans ; Leucovorin ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the clinical efficacy of paclitaxel combined with three-dimensional conformal ra-diotherapy(3DCRT) for advanced non-small cell lung cancer(NSCLC) in the elderly. Methods From June 2011 to June 2013, 51 elderly patients with NSCLC were randomly divided into chemoradiotherapy group (n=26) and chemotherapy group(n=25). All patients were treated with weekly 60 mg/m2 of paclitaxel intravenously for 3 weeks, and patients in the chemoradiotherapy group were also treated with three-dimensional conformal radiation (1.8~2.0 Gy per fraction, 5 times per week, total dose of 60~66 Gy). The clinical efficacy and adverse reactions were compared between two groups. Re-sults In chemoradiotherapy group, the response rate was 84.6% and the overall efficiency rate was 96.2%, which were higher than 60.0% and 84.0% in chemotherapy group (P<0.05). In chemoradiotherapy group, the one year survival rate was 79.2%, which was higher than 61.5% in chemotherapy group (P<0.05), so did one year progression free survival rates (67.4% vs 40.0%)(P<0.05). The main side effects were gastrointestinal toxicity, radiation esophagitis and bone-marrow suppression. Conclusion Paclitaxel combined with three-dimensional conformal radiotherapy for advanced NSCLC in the elderly are safe and effective, the toxicity is tolerable.