Immunosuppressants are the most commonly used therapeutic means to reduce organ transplantation rejection and improve short-term clinical outcomes of patients after transplantation. However, systemic use of immunosuppressants increases the risk of opportunistic infections and the incidence of malignancies. Therefore, the efficient targeted delivery of immunosuppressants to target organs is particularly important. Lymph nodes are the main sites of transplant rejection activation. In recent years, drug delivery systems targeting lymph nodes have played an increasingly important role in the treatment of organ transplant rejection. This review briefly introduces the mechanism of action of lymph nodes in transplant rejection, and focuses on the construction of lymph node targeted drug delivery system and its application in transplant rejection, aiming to apply it in the treatment of transplant rejection toimprove patient outcomes.

Objective:To investigate the relationship between cumulative fasting blood glucose(cumFPG)exposure and all-cause mortality.Methods:The prospective cohort study included 56 845 subjects of Kailuan Group who participated in physical examinations from 2006 to 2007, 2008 to 2009, and 2010 to 2011 with complete data and a median of 7.77 years of follow up. The end point event was all-cause mortality. The incidence of all-cause mortality was compared in various groups divided by four quartile of cumFPG. The Cox proportional hazards model and natural spline were used to analyze the effect of cumFPG on all-cause mortality.Results:During the average(7.77±1.05)years of follow-up, the incidence density of all-cause mortality was on the rise with the increase of cumFPG(4.93, 5.87, 8.48, and 14.02 per 1 000 person-years), with statistically significant difference by Log- rank test( P<0.001). Cox proportional hazards model showed that after adjusting for potential confounding factors(age, sex, body mass index, hypertension, baseline fasting plasma glucose), the HR value(95% CI)of all-cause mortality in the fourth quartile group was 1.28(1.15-1.42)compared to the first quartile. When cumFPG increased every standard deviation, the risk of all-cause mortality increased by 17%. Natural spline analysis exhibited a similar J curve relationship between cumFPG and all-cause mortality. Conclusion:High cumFPG is a risk factor of all-cause mortality.

Objective:To study the efficacy of different systemic chemotherapy regimens as first-line and second-line therapy and to determine the prognostic factors for patients with advanced biliary tract cancer.Methods:The clinical data of patients with advanced biliary tract cancer who underwent systemic chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2018 were studied. The efficacy of chemotherapy on objective response rate (ORR) and disease control rate (DCR) were evaluated. Potential prognostic factors for survival were studied using the Cox proportional hazards models.Results:Of 151 patients enrolled into this study, there were 75 males and 76 females, with ages ranging from 31 to 77 years (median 58 years). Two treatment protocols were used: (1) 104 patients received a gemcitabine-based regimen (combined with platinums or fluorouracils) or a combination of platinums and fluorouracils, while (2) 47 patients received a combination of albumin-bound paclitaxel and S-1. The corresponding ORR for each group were 15.4%(16/104) and 27.6%(13/47), respectively, and the DCR were 65.4%(68/104) and 72.3%(34/47), respectively. Of 58 evaluable patients who received chemotherapy as a second-line therapy, 31 patients received the regimen containing gemcitabine, platinums or fluorouracils with an ORR of 3.2% (1/31) and a DCR of 35.5%(11/31); a total of 18 patients received the taxanes-based regimen with an ORR of 11.1%(2/18) and a DCR of 38.9%(7/18); 9 patients received the irinotecan-based regimen with an ORR of 22.2%(2/9) and a DCR of 44.4%(4/9). Univariate analysis showed positive liver metastasis and elevated carbohydrate antigen (CA)19-9 level to be significantly correlated with worse survival outcomes ( HR=1.540, 95% CI: 1.019-2.328, P=0.040 and HR=1.892, 95% CI: 1.123-3.188, P=0.017). Conclusion:For patients with advanced biliary tract cancer, in addition to the conventional regimens containing gemcitabine, platinums and fluorouracils, the combination of albumin-bound paclitaxel and S-1 was shown to be an effective chemotherapeutic regimen for these patients. Second-line chemotherapy was insufficient and ineffective, and an irinotecan-based regimen deserves to be further investigated. Liver metastasis and elevated CA19-9 level were worse prognosis after chemotherapy for patients with advanced biliary tract cancer.

Objective:To explore the effect of systolic blood pressure (SBP) trajectories on cancers.Methods:The relevant data of 54, 888 employees of Kailuan (Group) Limited Liability Company who participated in the 3 health examinations from 2006-2007, 2008-2009, 2010-2011 were collected and the new onset cancer cases were recorded. The systolic blood pressure trajectory grouping was carried out using the blood pressure measurement values of the 3 physical examinations. The life table method was used to calculate the incidence of cancer, and the multivariate Cox proportional hazard regression model was used to analyze the influence factors of cancer.Results:According to the systolic blood pressure trajectory, 54, 888 subjects were divided into 5 groups, including 14, 326 in the low-stable group, 25, 630 in the moderate-stable group, 5, 390 in the moderate-increasing group, 6, 438 in the elevated-lowering group, and 3, 104 in the elevated-stable group. A total of 1, 070 new onset cancer occurred during the follow-up period of (4.95±0.53) years. The incidence of cancer in the low-stable group, moderate-stable group, moderate-increasing group, elevated-lowering group and elevated-stable group were 1.3% (177/14, 326), 2.2% (491/25, 360), 3.1% (147/5, 390), 2.7% (156/6, 438) and 3.8% (99/3, 104), respectively, the difference was statistically significant ( P<0.001). After adjusting for gender, age, smoking, drinking, physical exercise, body mass index (BMI), fasting blood glucose, total cholesterol, antihypertensive drugs, hypoglycemic drugs, and lipid-lowering drugs, multivariate Cox regression analysis showed that the systolic blood pressure trajectory was related to the incidence of cancer. Compared with the low-stable group, the Hazard ratio ( HR) in the moderate-stable group, moderate-increasing group, elevated-lowering group and elevated-stable group were 1.413, 1.731, 1.557 and 1.907, respectively (all P<0.001). Conclusion:High systolic blood pressure trajectories is the risk factor for cancer.

Objective:To explore the effect of systolic blood pressure (SBP) trajectories on cancers.Methods:The relevant data of 54, 888 employees of Kailuan (Group) Limited Liability Company who participated in the 3 health examinations from 2006-2007, 2008-2009, 2010-2011 were collected and the new onset cancer cases were recorded. The systolic blood pressure trajectory grouping was carried out using the blood pressure measurement values of the 3 physical examinations. The life table method was used to calculate the incidence of cancer, and the multivariate Cox proportional hazard regression model was used to analyze the influence factors of cancer.Results:According to the systolic blood pressure trajectory, 54, 888 subjects were divided into 5 groups, including 14, 326 in the low-stable group, 25, 630 in the moderate-stable group, 5, 390 in the moderate-increasing group, 6, 438 in the elevated-lowering group, and 3, 104 in the elevated-stable group. A total of 1, 070 new onset cancer occurred during the follow-up period of (4.95±0.53) years. The incidence of cancer in the low-stable group, moderate-stable group, moderate-increasing group, elevated-lowering group and elevated-stable group were 1.3% (177/14, 326), 2.2% (491/25, 360), 3.1% (147/5, 390), 2.7% (156/6, 438) and 3.8% (99/3, 104), respectively, the difference was statistically significant ( P<0.001). After adjusting for gender, age, smoking, drinking, physical exercise, body mass index (BMI), fasting blood glucose, total cholesterol, antihypertensive drugs, hypoglycemic drugs, and lipid-lowering drugs, multivariate Cox regression analysis showed that the systolic blood pressure trajectory was related to the incidence of cancer. Compared with the low-stable group, the Hazard ratio ( HR) in the moderate-stable group, moderate-increasing group, elevated-lowering group and elevated-stable group were 1.413, 1.731, 1.557 and 1.907, respectively (all P<0.001). Conclusion:High systolic blood pressure trajectories is the risk factor for cancer.

Objective: To investigate the association between sleep duration and brachial-ankle pulse wave velocity (baPWV). Methods: A cross-sectional study method was used to observe 38 604 employees of Kailuan Group who participated in the physical examination and the baPWV test from January 2010 to July 2018. The age was (51.6±11.1) years old. There were 72.4% (27 955/38 604) male participants. According to the sleep duration, subjects were divided into 5 groups including ≤ 5 hours group (3 762 cases),>5 hours and ≤6 hours group (9 585 cases),>6 hours and ≤7 hours group (12 604 cases), >7 hours and ≤8 hours group (11 921 cases) and >8 hours group (732 cases). Multivariate logistic regression model was used to analyze the association between sleep duration and the baPWV. Results: The age was (51.6±11.1) years old. There were 72.4% (27 955/38 604) male participants. The prevalence of baPWV≥14 m/s in ≤ 5 hours group, >5 hours and ≤6 hours group, >6 hours and ≤7 hours group, >7 hours and ≤8 hours group, and >8 hours group was 63.5% (2 389/3 762), 58.9% (5 645/9 585), 55.0% (6 926/12 604), 53.3% (6 356/11 921) and 54.8% (401/732) respectively. After adjusting for confounding factors including age, gender, smoking, drinking, physical exercise, snoring, hypertension, diabetes mellitus, dyslipidemia, body mass index≥24 kg/m², mean arterial pressure, heart rate, and C-reactive protein, the multivariate logistic regression analysis showed that the OR were 1.48 (95%CI 1.29-1.70, P<0.01) and 1.18 (95%CI 1.07-1.30, P<0.01) respectively for baPWV≥14 m/s in ≤ 5 hours and >5 hours and ≤6 hours group when compared with >7 hours and ≤ 8 hours group. Conclusion Short sleep duration is associated with elevated baPWV in mid-aged Chinese population.

Objective To investigate correlation of right ventricular hypertrophy and vitamin D , atrial fibrillation and NT-proBNP in patients with pulmonary heart disease.Methods 40 cases of pulmonary heart disease were selected, according to whether the right ventricular hypertrophy or not, and divided into hypertrophy group and non hypertrophy group.Echocardiography, serum 25 hydroxy vitamin D, 24 h dynamic electrocardiogram and NT-proBNP level were detected, and the correlation were detected between the right ventricular hypertrophy and influence factors.ResuIts The right ventricular anterior wall ( RVAW) and right ventricular diastolic diameter ( RVDd) in hypertrophy group were significantly greater than those in non hypertrophy group (P<0.05).The serum 25 hydroxy vitamin D levels in hypertrophy group was lower than that in non hypertrophy group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and 25 hydroxy vitamin D levels(r=-0.189,P=0.424).The thickness of right ventricular anterior wall in atrial fibrillation group was greater than that in non atrial fibrillation group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and atrial fibrillation times(r=0.178,P=0.452).Serum NT-proBNP levels in hypertrophy group was higher than that in non hypertrophy group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and serum NT-proBNP levels(r=-0.105, P=0.660).ConcIusion Patients with right ventricular hypertrophy of pulmonary heart disease who has a lower serum 25 hydroxy vitamin D level and a higher NT-proBNP level.Patients with atrial fibrillation has a thicker RVAW.However, there was no correlation of above influence factors.

Objective This research aimed to investigate the function mechanism of lung injury after acute pulmonary embolism.Methods 30 healthy New Zealand rabbits were selected and randomly divided into five groups:control group (with venepuncture applied) and model groups including none-saline (NS) control group,exogenos laptin low doses group,medium dose group and high dose group.ELISA was applied to examine the TNF-αand IL-1β in serum.Results TNF-α and IL-1β content in saline group were higher than that in control group,and the results were statistically significant.In medium dose (50 μg/kg) group,TNF-α and IL-1β levels decreased apparently and the results were statistically significant.In low doses (20 μg/kg) group,TNF-α and IL-1β levels decreased,but the results were not statistically significant.In high dose (100 μg/kg) group,TNF-α and IL-1β levels increased on the contrary.Conclusion Suitable dose of leptin will lead the decrease of postoperative levels of TNF-α and IL-1β after acute pulmonary embolism,which thus have protection function to the injured lung.

0.1), but which were inhibited significantly in the left ventricular cardiac myocytes of the subjects with heart failure(P≤0.05). Both carvedilol and metoprolol exhibited no effect on eNOS activity in all the investigated cardiac myocytes. CONCLUSIONS: Nebivolol does no effect on eNOS activity of left ventricular cadiocytes in subjects or rats without hear failure but it can inhibit eNOS activity of cadiocytes in subjects or rats with heart failure so as to exert its beneficial clinical effect.

OBJECTIVE:To study the efficacy of Urokinase vs.Low Molecular Weight Heparin in the treatment of acute pulmonary thromboembolism.METHODS:A total of 35 patients with acute pulmonary thromboembolism who had no past history of heart and lung diseases were enrolled and randomly assigned to two groups following ultrasonography and pulmonary ventilation/perfusion scanning:15 were given thrombolysis therapy with urokinase,and 20 given anticoagulation therapy with low molecular weight heparin.Symptoms,arterial blood gas analysis,electrocardiogram,echocardiogram were compared in two groups before and after treatment.RESULTS:The patients receiving thrombolysis therapy had better improvement in symptoms,arterial blood gas index,echocardiogram and the pulmonary ventilation/perfusion scanning than in those receiving anticoagulation therapy(P