Anthropometry ; methods ; Humans ; Sleep Apnea, Obstructive ; diagnosis

Objective To investigate the causes of acute renal failure(ARF)after orthtopic liver transplantation(OLT)in patients of acute liver failure(ALF)and the effects of systemic therapy based on continuous renal replacement(CRRT).Methods Clinical data of 412 patients who underwent liver transplantations between January 2001 and June 2006 were analyzed retrospectively (all the cases were followed up to June 2007).According to UNOS grading scale,54 patients were of acute liver failure(UNOS 1 and 2A).Posttransplant ARF developing in 17 cases underwent a systemic therapy based on CRRT as well as anti-rejection,anti-infection and nutrition support.The perioperative courses,complications,causes of death and follow up results were analyzed.Results There were no severe complications during CRRT.Perioperative mortality was 5.4%and 58.8%in patients without ARF and those with ARF respectively.the rate of complications was 35.1%vs 100%.1 year survival rate Was 89.2% vs 41.2%.3 year survival rate was 81.1% vs 41.2%.Condusions The effect of surgery mainly depends on the function of liver and other vital organs.The ALF recipients suffered from a high perioperative mortality,especially those with posttransplant ARL.The systemic therapy based on CRRT benefits patients with postoperative ARF.

ObjectiveTo compare orthotopic liver transplantation (OLT)and combined liverkidney transplantation (CLKT) in the treatment of severe hepatitis B.MethodsIn this study 52 patients of severe hepatitis B were allocated to OLT (40 cases) or CLKT( 12 cases) at our department from Jan.2001 to Sep.2005.The perioperative complications and the result of follow-up were analyzed.ResultsThe preoperative renal functions in CLKT cases were severer than that in OLT cases.Postoperative severe infection was more common in CLKT cases than that in OLT cases.In OLT group 28 patients (70％)suffered from early posttransplant renal dysfunction,among them 11 patients needed dialysis,whilst there were 2 (16.7％ ) patients who needed dialysis in CLKT group (P ＜0.01 ).The posttransplant mortality in OLT group was 40％ ( n =16),significantly higher than that in CLKT ( 16.7％,n =2) ( P ＜ 0.01 ).In OLT group,9 cases developed severe renal failure and died.No one died of renal failure in CLKT group.ConclusionsThe prognosis is more favorable to perform CLKT in patients who suffered from severe hepatitis B with chronic renal dysfunction before transplantation.

OBJECTIVESTo study perioperative inflammatory response status in patients with acute aortic dissection. To analyze the reason and outcome of the inflammatory activation.

METHODSBetween August 2011 and December 2011, 30 patients (22 male and 8 female, mean aged (43 ± 9) years) had undergone open repairs of aortic dissection or aneurysm with deep hypothermic circulatory arrest. Indications for surgical intervention were type A aortic dissection in 26 patients and aortic aneurysm in 4 patients. In detail, ascending aorta and arch replacement combined with stent elephant trunk were done in 29 patients, arch replacement combined with stent elephant trunk in 1 patient. According to the time from clinical onset of the dissection to operation, acute group (less than 7 days, group A) 20 patients, chronic group (more than 30 days and aortic aneurysm, group C) 10 patients. White blood cell, C-reactive protein and procalcitonin were assayed before and after operation. These valuables were recorded and compared statistically between two groups.

RESULTSThere were no significant differences in age, operation time, and blood transfusion volume (P > 0.05). Preoperative serum level of inflammatory indicators in group A were significant higher than in group C (t > 3, P < 0.05). Postoperative serum peak level of these indicators were significant higher than preoperative level in both groups (t > 4, P < 0.05). There were much more complications occurred on patients in group A (21 cases) than in group C (0 cases). The occurrence of early postoperative complications in group A was much higher than group C (χ(2) = 12.209, P = 0.000). Mechanic ventilation time in group A and group C were (35 ± 58) hours and (18 ± 9) hours respectively. ICU length of stay in two group were (49 ± 61) hours and (33 ± 12) hours, respectively. The patients with mechanic ventilation time more than 24 h, ICU length of stay more than 5 days in group A was more than in group C significantly (χ(2) = 5.161, P = 0.010; χ(2) = 3.657, P = 0.024).

CONCLUSIONSAcute aortic dissection and surgical procedure induce an acute phase inflammatory reaction. The patients with acute aortic dissection involved more serious organic injury and worse outcome following surgery compared with chronic aortic dissection.

Adult ; Aneurysm, Dissecting ; blood ; surgery ; Aortic Aneurysm ; blood ; surgery ; C-Reactive Protein ; metabolism ; Calcitonin ; blood ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Perioperative Period

OBJECTIVETo explore the feasibility of inducing human umbilical cord mesenchymal stem cells (HuMSCs) to differentiate into Leydig cells through conditioned medium derived from Leydig cells.

METHODSHuMSCs and Leydig cells were obtained by tissue blocks culture attachment and enzymatic digestion respectively. HuMSCs were induced by conditioned medium of Leydig cells as an experiment group while those before induction were cultured as a control group. The expressions of LHR, 3β-HSD and StAR in the induced HuMSCs were determined by RT-PCR after 3, 7 and 10 days of culture; those of CYP11A1, CYP17A1 and 3β-HSD measured by immunofluorescence staining after 2 weeks; and that of 3β-HSD detected by Western blot after 4 weeks.

RESULTSThe experimental group showed positively expressed LHR, 3β-HSD and StAR at 3, 7 and 10 days, CYP11A1, CYP17A1 and 3β-HSD at 2 weeks, and 3β-HSD at 4 weeks, while the control group revealed negative expressions at all the time points.

CONCLUSIONInduced with conditioned culture medium derived from Leydig cells, HuMSCs are likely to differentiate into steroidogenic cells and eventually into Leydig cells.

Cell Differentiation ; Culture Media, Conditioned ; Humans ; Leydig Cells ; cytology ; Male ; Mesenchymal Stromal Cells ; cytology ; Umbilical Cord ; cytology

ObjectiveTo evaluate the clinical efficiency and safety of cefmetazon in the prevention Department of General Surgery,First People's Hospital,Shanghai Jiaotong University,Shanghai 200080,Chinaand or treatment of infections in general surgery. MethodsA multicenter,prospective and open-labeled trial was conducted. In the prevention group,1700 patients were enrolled in clean-infection surgery,cefmetazon was given 1 g iv half an hour before the surgery started,and 1 g iv twice daily after the surgery for 3 days.Clinical response was evaluated in terms of both cure ( disappearance of pre treatment symptoms)and pathogen. In the treatment group,897 patients were diagnosed as peritonitis, cholecystitis and cholangitis,the patients were given cefmetazon 2 g iv twice a day for 7 - 14 days,clinical response and microbiological efficacy were assessed.ResultsIn prophylactic group,1449 patients were finally included.The clinical efficacy was 100％ (1449/1449).In the treatment group,a total of 897 patients were enrolled,and 110 patients failed for assessment of clinical efficacy,787 patients were included in the PPS population,the clinical efficacy was 90.7％ (714/787); Bacterial eradication rate was 92％ (46/50).Adverse reaction rates in prevention group and treatment group were 1.3％ (22/1700) and 1.2％ (11/897),including mild nausea and vomitting.ConclusionsCefmetazon is effective and safe in prevention and treatment of Postoperative infections in general surgery.

This study was purposed to investigate the inhibition of hTERT antisense oligodeoxynucleotide (ASODN) on the proliferation and telomerase activity in HL-60 cells and to explore the relativity between the telomerase activity and the expression of hTERT gene in HL-60 cells. After treated by hTERT ASODN the expression of hTERT was detected by RT-PCR, the morphological changes of HL-60 cells was observed with inverted microscopy, the cell proliferation was measured by MTT method, and the telomerase activity was determined with TRAP-ELISA and TRAP-PAGE. The results showed that after sealing hTERT gene with ASODN for 72 hours, the expression of hTERT gene was significantly inhibited, the cell growth was repressed and the ability of proliferation decreased, and the effect was specific in sequence and dependent in dose and time. OD(450-690) values were 2.648 +/- 0.42, 1.504 +/- 0.47, 1.223 +/- 0.39, 0.944 +/- 0.16 respectively, as the cells were treated with 0, 10, 20, 30 micromol/L ASODN for 72 hours. The difference was significant as compared 10, 20, 30 micromol/L groups with 0 micromol/L ASODN group respectively (P < 0.05), but the difference was no significant when compared 20 micromol/L SODN group (2.376 +/- 0.65) with untreated group (2.648 +/- 0.42) (P > 0.05). TRAP-PAGE detection revealed that comparing ASODN groups with SODN groups the telomerase image bands were decreased and least was found in groups of 30 +/- mol/L. It is concluded that the hTERT ASODN may inhibit the proliferation and down-regulate the telomerase activity in HL-60 cells by sealing the expression of hTERT gene.
Cell Proliferation ; drug effects ; HL-60 Cells ; Humans ; Oligonucleotides, Antisense ; biosynthesis ; genetics ; Telomerase ; biosynthesis ; genetics ; metabolism ; pharmacology ; Transfection

BACKGROUNDPax-6 gene plays an important role in the process of eye development. This study was to determine the role of pax-6 in the axial myopia produced by hyperopic optical defocus and form deprivation in infant monkeys.

METHODSAmong seven normal infant rhesus monkeys (aged 1 to 1.5 months), five wore -3.00 D spectacle lenses over their right eyes and zero-powered lenses over their left eyes. Monocular form deprivation was produced by eyelid fusion in two monkeys. Ten weeks later, the monkeys were sacrificed by an overdose of barbiturates and their eyes were removed immediately. A 5 mm x 5 mm button of retina and sclera was taken from the posterior poles along with a 4-mm optic nerve. RNA was isolated separately from each of these three types of tissues. After that, reverse transcription polymerase chain reaction (RT-PCR) was used for determining gene expression in the retina, sclera and optic nerve. Semi-quantitative analyses were performed on the PCR products.

RESULTSAs expected, the optically induced hyperopic defocus and the form deprivation produced myopic growth. For the lens-treatment monkeys, pax-6 gene expression in the retinas of the defocused eyes was significantly higher than in the retinas of the left eyes (t = 5.703, P = 0.005). However, there were no analogous significant differences between pax-6 expression in the scleras or the optic nerves. For the two form-deprived monkeys, there were no obvious differences in pax-6 gene expression in the retinas or the optic nerves.

CONCLUSIONThe result that the expression of pax-6 was enhanced by hyperopic defocus in the infant monkey retina suggests that pax-6 may be involved in vision-dependent eye growth and emmetropization.

Animals ; Eye Proteins ; Gene Expression Regulation ; Homeodomain Proteins ; genetics ; Macaca mulatta ; Myopia ; metabolism ; Optic Nerve ; metabolism ; PAX6 Transcription Factor ; Paired Box Transcription Factors ; Repressor Proteins ; Retina ; metabolism ; pathology ; Reverse Transcriptase Polymerase Chain Reaction ; Sclera ; metabolism

OBJECTIVETo study the effects of cadmium chloride in anterior pituitary and the relation between apoptosis and expression of procaspase-9 mRNA.

METHODSIn vivo studies:40 SD male rats were randomly distributed into four groups which were administered with CdCl2 at different doses by gavage for 6 weeks;

IN VITRO STUDIESthe rats' anterior pituitary cells were primarily cultured for 120 hours, then treated with CdCl2 at the dose of 0, 1.56, 3.12, 6.25, 12.50, 25.00, 50.00, 100.00 micromol/L for 6 hours; The indices included: expression of procaspase-9 mRNA, detection of apoptosis with TUNEL assay.

RESULTSThe results showed the excretion of ACTH, LH seemed to be decreased dramatically and the apoptosis inclined to enhance remarkably, and further more, the expression of procaspase-9 mRNA appeared to be increased significantly as compared with those of the control. It was show that a dose-effect relationship between the CdCl2 dosing and indices above with the regression analysis and a linear correlation between the mean gray value of apoptosis cell and the relative gray value of procaspase-9 mRNA positive cell. The results indicated that damnification, for example, apoptosis could be caused by certain dose of CdCl2 in anterior pituitary cells with dose dependent manner. Caspase-9 might play a role in the occurrence of apoptosis.

CONCLUSIONIt was suggested that cadmium could induce apoptosis of anterior pituitary both in vivo and in vitro in the manner of dose-dependent, and caspase-9 might play a role during above processes.

Animals ; Apoptosis ; drug effects ; Cadmium Chloride ; administration & dosage ; toxicity ; Caspase 9 ; genetics ; Cells, Cultured ; Dose-Response Relationship, Drug ; Male ; Pituitary Gland, Anterior ; cytology ; drug effects ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; drug effects

BACKGROUNDThe common γ chain (γc) plays a critical role in regulating proliferation, differentiation, and apoptosis of peripheral T-cells. It was previously confirmed that blocking the γc signal can successfully induce transplant tolerance in a murine model. Here we investigated the potential mechanism.

METHODSSplenocytes from C57BL/6 mice were transfused into T-cell deficient Balb/c nude mice that were reconstituted with syngeneic wild-type T-cells labeled with 5-carboxyfluorescein diacetate succinimidyl ester (CFSE). After 24 hours, recipients received i.p. injection of mixture of anti-γc mAbs, or with isotype control IgG2a. The labeled T-cells were harvested from recipient spleens after 12 and 48 hours. T-cell proliferation and apoptosis were detected by flow cytometry.

RESULTST-cell proliferation was markedly inhibited and apoptotic T cells could be detected at 12 hours after the mAbs injection. Proliferation was inhibited at 48 hours, but the proportion of apoptotic T-cells was not more than at 12 hours. In the control group, however, T-cells actively proliferated and no significant apoptosis was detected at either time point.

CONCLUSIONSThe results suggested that blockade of γc signals can synergize with donor splenocyte transfusion and lead to inhibition of antigen-specific T-cell proliferation and induction of apoptotic T-cell death. This protocol may develop a novel approach to induce donor-specific tolerance.

Animals ; Antibodies, Monoclonal ; pharmacology ; Apoptosis ; drug effects ; Cells, Cultured ; Flow Cytometry ; Fluoresceins ; Immune Tolerance ; drug effects ; Interleukin Receptor Common gamma Subunit ; antagonists & inhibitors ; metabolism ; Lymphocyte Activation ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Nude ; Signal Transduction ; drug effects ; Spleen ; cytology ; Succinimides ; T-Lymphocytes ; cytology ; drug effects