Objective To evaluate the prevalence,management and risk factors of post transplantation anemia (PTA) in a group of Chinese kidney transplant recipients after a long-term follow-up. Methods The clinical data of 154 adult kidney transplant recipients,who were followed up for at least 5 years,were retrospectively studied,including yearly hemoglobin (Hb) level,the prevalence and treatment of anemia,state of renal function,use of immunosuppressive agents and other medications. Patients were divided as anemic and non-anemic groups,and comparison of clinical data was carried out between the groups. The incidence of anemia was calculated and management of anemia was recorded. Monofactorial correlation analysis was used to determine the factors associated with Hb level,and multi-variation logistic regression was used to identify the factors related to the onset of anemia at 1 and 5 years post-transplant. Results The annual incidence of PTA at the current year of and 1 to 5 years after transplantation was 45.5%,10.7%,9.6%,14.8%,13.5% and 19.5%,respectively. About 38.3% of the patients suffered from anemia at least once during the 5 years of follow-up period,and 42% of these patients developed anemia recurrently. Correlation analyses indicated that Hb levels were associated with graft function (P0.05). Logistic regression model showed that serum creatinine and blood urea nitrogen levels were associated with the diagnosis of anemia in the 1st year after transplantation (P

Objective To investigate the effects of hypothermia combined with sevoflurane on expression of myocardial gap junction protein connexin 43 (Cx43) in isolated rabbit hearts.Methods Healthy adult rabbits of both sexes,weighing 1.5-2.0 kg,were sacrificed after anesthetization.The hearts were rapidly excised and perfused in a langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃ in a langendorff apparatus.Forty isolated hearts were randomly divided into 4 groups (n =10 each):control group (group C),hypothermia group (group H) and hypothermia combined with sevoflurane group (group HS).At 15 min of equilibration,the perfusion with K-H solution was continued at 37 ℃ in group C,K-H solution saturated with 2.4％ sevoflurane was perfused at 37 ℃ in group S,K-H solution was perfused at 30 ℃ in group H,and K-H solution saturated with 2.4％ sevoflurane was perfused at 30 ℃ in group HS.At 30 min of perfusion,myocardial specimens were obtained from the anterior wall of the left ventricle for detection of the expression of Cx43 in myocardial cells (by immunohistochemistry and Western blot).Results Compared with group C,Cx43 expression was downregualted in group H (P ＜ 0.05),and no significant change was found in Cx43 expression in S and HS groups (P ＞ 0.05).Cx43 levels distributed mainly in the intercalated disc in S and HS groups,and in H group the distribution of Cx43 levels in the intercalated disc was less,but the percentages of lateralized Cx43 were increased.Conclusion Sevofurane can inhibit hypothermia-induced down-regulation and distribution disturbance of myocardial Cx43 expression,which may be the mechanism by which sevofurane inhibits hypothermia-induced arrhythmia.

Objective To investigate the effects of hypothermia combined with sevoflurane on myocardial monophasic action potential (MAP) and transmural dispersion of repolarization (TDR) of the left ventricle in rabbits in vitro. Methods Adult rabbits weighing 1.5-2.0 kg were sacrificed after heparinized and anesthetized.The hearts were immediately removed and perfused with K-H soluation saturated with 95%O2-5%CO2 at 37℃ in a Langendorff apparatus. Forty-eight isolated hearts were randomly divided into 6 groups ( n = 8 each): Ⅰ control group (group C), Ⅱ low concentration sevoflurane group ( group S1 ), Ⅲ high concentration sevoflurane group (group S2 ), Ⅳ hypothermia group (group H), Ⅴ hypothermia + low concentration sevoflurane (group HS1 ) and Ⅵ hypothermia + high concentraion sevoflurane (group HS2 ).Group C received continous perfusion. Group S1and S2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 37 ℃ for 30 min respectively. Group H received perfusion with K-H solution at 30℃ for 30 min. Group HS1 and HS2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 30℃ respectively.MAPs of epicardium, mid-myocardium and endocardium of the left ventricle were recorded. MAP duration at 90%repolarization(MAPD90)and TDR were calculated. Early after-depolarization,delayed after-depolarization and arrhythmia were also recorded. Results Compared with group C, MAPD90 of the 3 layers of ventricle was significandy prolonged, the incidence of arrhythmia increased in group H (P＜0.05). There was no significant difference in TDR among all groups ( P＞0.05). There was no interaction between sevoflurane and hypothermia (P＞0.05), and it only showed that MAPD90 was prolonged by hypothermia (P ＜0.05 ). Conclusion Hypothermia combined with sevoflurane exerts no significant effects on myocardial MAP and TDR of ventricles in rabbits, and sevoflurane decreases the incidence of hypothermia-induced arrhythmia through inhibiting the prolongation of MAPD90.

AIM: To investigate the influence of dialysate on the cell morphology and the peritoneal membrane function in chronic peritoneal dialysis rats. METHODS: 40 SD rats were divided randomly into 4 groups. Except control group, other groups daily received infusion of 20 mL dialysate (4.25% dialysate(HG), 1.50% dialysate(LG), Riger's solution(RG)) respectively for 8 weeks. The peritoneal membrane function was investigated by peritoneal transport test, and the rat peritoneal mesothelial cells(PMCs)morphology was analyzed by the cell imprints. RESULTS: The intraperitoneal volume and net ultrafiltration in HG and LG groups were significantly lower, with D/P_(urea) significantly higher, and C_(urea) after 4 h of dialysis significantly lower than that in RG and control groups. The density of cell population from analysis of cell imprints in HG and LG groups was significantly lower, but the mean surface area were significantly larger than that in RG and control groups. These change had no difference between HG and LG group. Using the high glucose dialysate for 8 weeks significantly decreased the ultrafiltration volume ,which was significantly relate to the increasing of cell surface area (r=-0.896,P

Adult ; Carcinoma, Hepatocellular ; secondary ; Humans ; Liver Neoplasms ; secondary ; Lymphoma, Non-Hodgkin ; pathology ; Male ; Spinal Neoplasms ; pathology

Objective To analyze the detection rate of HBV serological makers in non-hepatic inpatients in the past six years. Methods Serum samples of 70 582 non-hepatic inpatients from three large hospitals were collected during 2003 to 2008. Serological markers of HBV ( HBsAg, anti-HBs, HBeAg, antiHBe and anti-HBc) were detected by the AxSYM MEIA system (Abbott Laboratories,Abbott Park,IL).Combining the test results of serological makers with other clinical data, several analysis models for this retrospective study were set up to evaluate the year-to-year changes in serological makers and the detection rates of each model. Results The order from high to low of detection rate of the 5 HBV serological markers was anti-HBc (55. 17% ), anti-HBs (49. 57% ), anti-HBe (28.42%), HBsAg ( 8. 92% ) and HBeAg (2. 12% ), and all of them had a downward trend in the past six years. The positive rate of HBsAg went down from 9. 30% (2003) to 8.70% (2008). The positive rate of HBsAg among people who were born after 1992 (2. 28% ) were significantly lower than that of the overall population (8. 92% ) and fell from 3.57%(2003) to 1.85% (2008). Each detection rate of all serological makers had male sexual side effect [HBsAg ( 12. 38%/7. 25% ), HBeAg ( 2. 72%/1.58% ), anti-HBc ( 56. 57%/53.43% ), anti-HBe (41.50%/28. 35% ) and anti-HBs (65.48%/50. 00% ), male/female]. The differences were statistically significant (Chi-square values of HBsAg, HBeAg, anti-HBc, anti-HBe and anti-HBs were 509.74,105.78, 69.66, 1 321.61 and 1 726.91, respectively; all P ＜ 0. 01).Twenty-six models of HBV serological makers from 70 582 inpatients were summed up, and 8 models had positive rates geater than or equal to 1%. The "All Negative" model ranked No. 1 and had no significant change from year to year. During the past six years, models representing "A11 Negative" and "anti-HBs Positive alone" were mainly in individuals younger than or equal to 20-year-old, while the models representing "anti-HBc and/or anti-HBe,anti-HBs Positive" were mostly in people older than 20-year-old. The distribution curve of models representing "HBsAg, HbeAg and anti-HBc Positive" and "HBsAg, anti-HBc, anti-HBe Positive"etc. showed a bell-shape, covering the population from 20-year-old to 70-year-old. Conclusions The slowlydescending tendency of the detection rates of HBV serological makers was observed during the past six years.The detection rates of HBV in the younger generation decreased significantly. However, the HBV infection rates of overall population is still high, so it is a high time that we made continuous improvement for the serum HBV screening technique in order to reduce the HBV infection ratess.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

Background Diabetes is one of the risk factors that leads to corneal neuropathy.Silent signal regulatory factor 1 (Sirt1) plays an important role in glucose metabolism,lipid metabolism,regulation of insulin secretion and is closely related to the nervous system disease.The relationship between Sirt1 and diabetic corneal neuropathy is not fully understood.Objective This study was to detect the expression of Sirtl in cornea and trigeminal ganglion with type 1 diabetes model mice and explore the association of Sirt1 expression with diabetic corneal neuropathy.Methods Eight C57BL/6-Ins2Akita/J male mice and eight wild-type C57BL/6 male mice in the same litter were selected as type 1 diabetes model group and control group,respectively.The mice of two groups were sacrificed in overdose anesthesia method at 12-month old.Histological examination of cornea and trigeminal ganglion was performed using hematoxylin and eosin staining.Expression and localization of Sift1 protein in cornea and trigeminal ganglion were detected using immunohistochemistry.Western blot assay and fluorescine quantitative PCR were respectively used to quantitatively analyze the expression of Sirt1 protein and Sirt1 mRNA.Results Trigeminal ganglion cells were uneven in size and shape with the loosened cellular arrangement and disorder neurofibrosis alignment,and the corneal epithelial cells were less in the C57BL/6-Ins2Akita/J mice,but the trigeminal ganglion cells and corneal epithelial cells were normal in wild-type C57BL/6 mice.Immunochemisty exhibited that Sirtl protein was expressed mainly in corneal epithelium and the expression of Sirtl protein was stronger in the C57BL/6 mice than that in C57BL/6-Ins2Akita/J mice.Fluorescine quantitative PCR assay showed that the gray scale value of Sirt1 mRNA in cornea in C57BL/6-Ins2Akita/J mice was lower than that of the wild-type C57BL/6 mice(0.56±0.03 vs.0.98±0.13) with significant difference (t =5.853,P =0.010).Western blot showed that the expression of Sirt1 protein in cornea was lower in C57BL/6-Ins2Akita/J mice than that of the wild-type C57BL/6 mice(0.78±0.017 vs.1.300±0.012) with significant difference(t =33.140,P =0.001).However,no significant differences were seen in the gray scale value of Sirt1 mRNA(2.45±0.18 vs.2.51±0.22) (t=0.587,P=0.599) and protein level(1.100±0.015 vs.1.110±0.017) (t =0.430,P=0.709) in trigeminal ganglion tissues between C57BL/6-Ins2Akita/J mice and wide-type C57BL/6 mice.Conclusions The corneal nerve and structure is abnormal in 12-month-old C57BL/6-Ins2Akita/J mouse.Sirt1 is involved in the pathogenesis of diabetic keratoneuropathy,suggesting that it may be a potential target.

Background Selective laser trabeculoplasty (SLT) plays lowing-intraocular pressure (IOP)effect by irradiating pigmented trabecular cells selectively using 532 nm Nd:YAG laser.However,its affect pattern is not fully known.Objective This study was to establish a human trabecular cells (HTCs) model of SLT effect,and to observe the morphological changes of HTCs after they were exposed to different energies of SLT.Methods Immortalized HTCs were incubated in DMEM/F12 with pigmental granules for 16 hours (overnight) to prepare pigmented trabecular cells.The cells were irradiated with modified laser lens with the spot of 400 μm and emitting duration of 3 ns.The energy scale of 0.2 mJ was set for standardized energy and 0.1 mJ was used as the low energy.The morphology and ultrastructure of the cells were examined under the light microscope and transmission electron microscope 1 hour,4,8,12,24 hours after irradiation.Trypan blue staining and TUNEL fluorescence staining were used to evaluate the death and apoptosis of the cells after laser irradiation.Results The brown pigment particles were seen in cytoplasm around nuclei of trabecular cells after cultured for 16 hours.After laser irradiation,there was no obvious change in the shape of nonpigmented trabcular cells,but a 400 μm spot was found in the pigmented trabecular cells under the light microscope,and the pigmented particles released as the cell disruption.After 0.2 mJ laser irradiation,cell loss zone was seen at the center of the laser spot,and the positive cells for trypan blue and TUNEL staining were found;while the abnormal manifestations were slight after the 0.1 mJ irradiation.With the lapse of the time,the number of positive staining cells was gradually decreased.Twenty-four hours after laser irradiation,proliferative trabecular cells emerged and migrated to the center area of laser spot.Statistical analysis showed that the numbers of the positive cells for trypan blue and TUNEL staining were significantly reduced in the lower energy group in comparison with the standardized energy group at various time points (all at P＜0.001),and those of both energy groups were gradually reduced with lapse of time with the significant differences between any two time points (all at P＜0.01).Conclusions An in vitro laser effect model of HTCs can be established by exposing pigmented HTCs to SLT laser.After exposed to SLT,the gasification,necrosis-like death,apoptosis-like change appear at the laser center.The laser destroyed cells can be replaced by proliferative cells with the lapse of time.Low-energy laser irradiation cause a similar morphological change of the cells to high-energy irradiation,but the number of abnormal cells is much less.

Background Selective laser trabeculoplasty (SLT) can increase the outflow of aqueous humor and reduce the intraocular pressure of patients with open angle glaucoma,but its mechanism is unknown.To investigate the mechanism of SLT would improve the therapeutic effect of SLT.The aqueous outflow resistance in trabecular meshwork was affected by the extracellular matrix (ECM).Matrix metalloproteinase-3 (MMP-3) and MMP-9 were closely related to ECM degradation in trabecular meshwork.Objective This study was to observe the effects of SLT on the expressions MMP-3 and-9 in human trabecular ceils in vitro.Methods Immortallized human trabecular cells were cultured with pigment particles mixed suspension for 16 hours and incubated overnight.Then the cells were irradiated with Q switch frequency doubling 532 nm Nd:YAG laser to establish SLT-effective cells with the energy of 0.2 mJ,spot diameter of 400 μm and pulse duration of 3 ns.The expressions of MMP-3 mRNA and MMP-9 mRNA in the cells were detected by fluorescence quantitative real time PCR before and 1 hour and 4,8,12,28 hours after exposure of laser.The concentrations of MMP-3 and MMP-9 in the medium were assayed using ELISA 1 hour and 4,8,12,28 hours after exposure of laser and compared between the non-irradiation group and the irradiation group.Results The relative expressing levels of MMP-3 mRNA were 1.00,1.32±0.12,2.08±0.05,2.34±0.04,2.77± 0.05 and 2.49±0.27 in the non-irradiation group and irradiation for 1 hour and 4,8,12,28 hours after exposure of laser SLT,showing a significant difference among the groups (F =15.966,P=0.007),and relative expressing levels of MMP-3 mRNA were significantly higher in various time points after laser irradiation than those of the non-irradiation group (all at P＜0.05).The relative expressing levels of MMP-9 mRNA were 1.00,0.91 ±0.10,1.27 ± 0.07,1.46±0.07,1.69±0.09 and 0.87±0.09 in the non-irradiation group and irradiation for 1 hour and 4,8,12,28 hours after exposure of SLT,which was considerably different among the groups (F =30.526,P =0.005),and significant increased values were seen in the 4,8 and 12 hours after irradiation compared with the non-irradiation group (all at P＜0.05),with highest expression in the irradiation for 12-hour group.The concentrations of MMP-3 and MMP-9 proteins in medium were significantly increased in various time points after laser exposure in comparison with the control group (all at P＜0.05).Conclusions The expressions of MMP-3 and MMP-9 in human trabercuolar cells upregulate and the secretion ability of human trabecular cells to MMP-3 and MMP-9 proteins improves in early stage of SLT in vitro.However,these procedures gradually diminish with the lapse of time.