Objective To observe the effect and study intervenient action of Kuijieling Granules (KG) in treating ulcerative colitis (UC) during the active period by the clinical experiment. Methods The patients of active UC (damp-heat syndrome) were randomly divided into 2 groups (KG+SASP group and SASP group) to observe pathological changes of the mucosa,syndrome effect and main symptoms scores,and the protein expression of TLR4,CD14 and NF-?B p65 were detected by immunohistochemistry. Results KG+SASP group had better effect than SASP group in syndrome and mucosa (P0.05). There were outstanding differences among the pathologic grade of UC about IA of TLR4,CD14 and NF-?B p65. The expression of TLR4,CD14 and NF-?B p65 were decreased by treatment (P

Objecitve To investigate the relationship between the level of pregnancy-assoiated plasma protein-A(PAPP-A) and high-sensitivity C-reactive protein(hs-CRP) in patiente with acute coronary syndrome(ACS) and the role of PAPP-A in predicting the stability of atherosclerotic plaques.Methods A total of 43 patients were selected as ACS group,25 patients as stable angina(SA) and 13 persons as control.ACS group ansisted of 20 patients with unstable angina(UA) and 23 patients with acute myocardial infarction(AMI).The peripheral venous blood samples of the both control and angina groups were drawn on the morning of the following day after hospitalization, and of the AMI group were drawn 24 hours after episode.The concentration of PAPP-A was detected by enzyme-linked immune sorbent assay(ELISA),and the concentration of C-reactive protein(CRP) was detected by scatter turbidimetry method.The concentration of PAPP-A and CRP in each group was compared.Results The plasma hs-CRP and PAPP-A levels in patients with AS increased significantly compared with those in UA and healthy volunteers; PAPP-A was significantly related with hs-CRP(r=0.308);using the method of multiple regression and correlation PAPP-A had linear relationship with hsCRP in all of the cases.Conclusion PAPP-A can play a role in evaluating the clinical stability of patients with coronary disease,and may serve as one of the biomarkers of vulnerable plaques.

AIM: To investigate the role of HGF/c-Met signaling pathway in crizotinib-induced apoptosis of different lung carcinoma cell lines and to analyze its potential regulatory mechanisms .METHODS: EML4-ALK positive cell line H2228, c-Met proliferation cell line H1993 and control cell line A549 were treated with crizotinib at different doses for different time periods .The viability of the cell lines was measured by MTT assay .The apoptosis was analyzed by flow cytometry with PI staining.The protein levels of MET and phosphorylated MET (p-MET) of HGF/c-Met signaling pathway as well as its down-stream key proteins AKT , ERK, p-AKT and p-ERK in the cell lines before and after crizotinib treatment were examined by Western blot .RESULTS:The growth of H1993, H2228 and A549 cell lines was inhibited after crizoti-nib treatment for 72 h in a dose-dependent manner .Apoptotic rates of H1993 cells and H2228 cells were increased with the crizotinib concentration and exposure time .Down-regulation of p-MET, p-AKT and p-ERK at protein levels in H1993 cells and H2228 cells after exposure to crizotinib for 72 h was confirmed by Western blot .No obvious change of the related-pro-teins of HGF/c-Met signaling pathway was found in A 549 cell line.CONCLUSION: HGF/c-Met signaling pathway may contribute to crizotinib-induced apoptosis of H1993 cells and H2228 cells, which provides the experimental basis for MET-targeting treatment of lung cancer .

Objective To discuss the improvement of surgical techniques and adjustment of immunosuppressive regimen for combined liver and intestinal transplantation.Method A male patient with liver dysfunction and short bowel syndrome underwent the combined liver and intestinal transplantation.Ostomy of graft was performed instead of intestinal anastomosis during the operation.The anastomosis of graft and autologous intestine was performed 8 months after transplantation.Hospital and follow-up data of the patients were analyzed retrospectively.Result The functions of liver and small bowel recovered smoothly after operation.Slight rejection occurred one month after operation with normal function of intestine but dysfunction of liver.In the first month after operation, abdominal infection was controlled by intraperitoneal drainage with open surgery.Immunosuppression protocol was administrated with alemtuzumab for induction plus maintenance treatment with tacrolimus, and mycophenolate mofetil was added because of renal dysfunction 2 years after transplantation.The patient was followed up for nearly 3 years with good quality of life without rejection and infection.Conclusion Combined liver and intestinal transplantation could improve patient's life quality and extend the survival time through the improvement of surgical techniques and individual immunosuppressive regimen.

Objective To investigate the effects of treatment on end-stage liver disease and diabetes mellitus by simultaneous liver-pancreas-duodenum transplantation with the pancreas of the recipients reserved.Method Simultaneous liver-pancreas-duodenum transplantations were carried out in three patients with the pancreas of the recipients reserved.The diseases of the recipient 1,2,and 3 were alcoholic liver cirrhosis and diabetes mellitus,chronic hepatitis B liver cirrhosis and diabetes mellitus,and chronic hepatitis B liver cirrhosis and diabetes mellitus complicated with renal function failure.The recipient 3 received simultaneous renal transplantation.Result The recipient 1 suffered from pancreatitis after the operation and discharged with normal liver function and blood glucose levels,and he was treated with insulin at 4th year after the operation.Intestinal fistula occurred in the recipient 2 and drainage was done without acute peritonitis,the liver allograft was experienced an acute rejection episode treated by intravenous bolus methylpredisolone at 19th month after operation,but gastrointestinal perforation happened and the patient died of acute peritonitis.In the recipient 3,peripancreatic effusion and pancreatitis happened and were treated by drainage,and the recipient survived to now with normal liver and kidney functions,but given insulin at first year after operation.Conclusion It is effective to implement simultaneous liver-pancreas-duodenum transplantation with the pancreas of the recipients reserved on the patients with end-stage liver disease and diabetes mellitus.However,how to maintain the pancreatic endocrine function after the transplantation for a long period awaits further investigation.

objective To investigate the differentiation of bone marrow-derived mesenchymal stem cells into neurons and transplantation of the stem ceils to repair rat hemisection spinal cord injury.Methods Adherent culture was used to isolate and culture rat bone marrow mesenchymal stem cells(MSCs).The rat spinal cord homogenate supernatant was used to induce neural differentiation of the 3rd generation ceils.The nature of ceil differentiation was identified by immunohistochemistry.The rat model of hemisection spinal cord injury was prepared and BrdU was locally injected to label the induced neurons.The distribution of living cells in the injuried spinal cord was observed at 5 weeks after cell transplantation.Results MSCs were spindle and polygonal,with 1-2 nucleoli seen under the inverted microscope.After induction with spinal cord homogenate supernatant there were a number of slender cytoplasmic projections forming interwined network and showing nestin expression,therefore,indicating the neuronal nature.MSCs at 5 weeks after transplantation into the spinal cord injury were surviving and their expression of MAP-2,NF,GFAP was significantly higher than that in the control rats(P<0.05).The rat motor function was improved than before transplantation.Conclusion MSCs induced by spinal cord homogenate supernatant can be transplanted into hemisection spinal cord injury and improve the motor function of the injuries lesions.

Objective To discuss the surgical procedures and treatment after combined liver and intestinal transplantation with portal venous drainage and enterostomy of two ends in one case.Methods A male patient with liver dysfunction and short bowel syndrome underwent the combined liver and intestinal transplantation.With the techniques of en bloc,the liver and intestinal grafts were harvested from cadaveric donor.The intestinal graft,200 cm long,was implanted with portal venous drainage and aortic inflow,and enterostomy of both ends was performed instead of intestinal anastomosis.The liver graft was placed in a piggyback fashion with end to end anastomosis of the bile ducts without T tube. Inmunosuppression protocol was administrated with campath-1H and tacrolimus.Endoscopic biopsy of intestinal graft was performed regularly,and clinical observation was done to monitor the acute rejection.Results In the first month after operation,abdominal infection was controlled by intraperitoneal drainage with open surgery.One suspect acute rejection was treated with methylprednisolone.Until sixth month,the functions of liver and intestine were progressively restored.However,the patient lost weight and could not be free from intravenous nutrition because of diarrhea.Conclusion Combined liver and intestinal transplantation with portal venous drainage and enterostomy of two ends is a simple surgical procedure with lower risk of surgical complications.This method is propitious to monitoring rejection and function improvement of the grafts.Diarrhea and loss of digestive juice are the main reasons of low body weight and malnutrition.

Objective:To explore the clinicalfactors related to allograft fibrosis after pediatric liver transplantation.Methods:The clinical data were respectively analyzed for 94 pediatric recipients from January 2013 to December 2016 at Tianjin First Central Hospital.The Patients were assigned into fibrotic and non-fibrotic groups based upon the results of protocol liver biopsies. Univariate and multivariate Logistic regression analyses were performed for examining the risk factors of fibrosis after pediatric livertransplantation. Then Logistic regression model was established to obtain the predicted value of combined predictive factors.Thereceiver operating characteristic curve (ROC) was conducted to evaluate the predictive value of combined predictive factors.Results:A total number of 54(57.5%) patients occurred fibrosis among the 94 patients. There weresignificant differences in cold ischemia time (Z=2.094), warm ischemia time (Z=2.421), biliary stricture( χ2=4.560), drug-induced liver injury ( χ2=7.389), hepatic artery thrombosis and rejection ( χ2=6.955)between two groups ( P<0.05). Logistic regression analysis showed that cold ischemia time (OR=1.003, 95%CI: 1.000~1.007, P=0.044), biliary stricture(OR=6.451, 95%CI: 1.205~33.295), rejection(OR=2.735, 95%CI: 1.057~7.077)and drug-induced liver injury (OR=4.977, 95%CI: 1.207~20.522, P=0.026) were independent risk factors for fibrosis 5 years after liver transplantation. The area under the ROC curve was 0.786(95%CI: 0.691~0.881), for predicting patient outcome.If using 0.311as a cutoff Value, the sensitivity was 90.70%, and the specificity was 60.00%. However, through the ROC curve comparison, there was statistical significance between combined predictive factors and the other independent risk factors ( P>0.05). Conclusions:The incidence of fibrosis 5 years after pediatricliver transplantation is 57.5%. Prolonged cold ischemia time, biliarystricture, rejectionand drug-induced liver injury after liver transplantation are independent risk factors for fibrosis 5 years after pediatric liver transplantation.And the combined predictive factors have a high predictive value forallograftfibrosis.

Objective To investigate the safety and efficacy of total thoracoscopic pneumonectomy for malignant lesion from a single-center pneumonectomy database.Methods A retrospectively analysis of 43 cases of malignant lesions in patients underwent total thoracoscopic pneumonectomy from surgical database of Shanghai Pulmonary Hospital from December 2013 to August 2017 was conducted,and then the mortality,complications,and disease recurrence were summarized.Results All lesions in 43 patients were pathologically comfirmed malignant,including 39 non-small cell lung cancers and 3 small cell lung cancers and 1 pulmonary metastasis.Complete thoracoscopic pneumonectomy was pedormed in 43 patients.The average operation time was (181.1 ± 68.0) min,blood loss was (146.5 t 113.6) ml,mean tube length was (8.4 ± 3.4) days.Perioperative mortality was 2.3％ (1/43).The complication rate of grade 3 or above was 16.3％.Median follow-up was 18 months,with 9 cases occuning local recurrence or distant metastasis;6 cases suffered from cancer-related death while non-cancer related death happened in 1 patient.Conclusion For selected locally advanced pulmonary malignant lesion,total thoracoscopic pneumonectomy is an alternative to open thoracic surgery with a better perioperative safety and satisfied mid-term oncologic survival.