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30 December 2012, Volume 16 Issue 53 Previous Issue    Next Issue

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Y-chromosome in situ hybridization technology for detection of transplanted hepatic stem cells in the liver graft Li Zhu, Chen Juan, Li Xue-hua, Liu Zhi-heng, Liu Gui-jie, Zhang Xue-li, Gao Yan-chao, Sun Hui-dong,Ji Pi- you,Zhang Jin-liang, Li Li 2012, 16 (53):  9881-9886.  doi: 10.3969/j.issn.2095-4344.2012.53.001 Abstract ( 328 )   PDF (604KB) ( 641 )   Save BACKGROUND: The colonization tracer technology after stem cells transplantation includes magnetic probe labeling, fluorescent tracer method, lentivirus infections fluorescent labeling and Y chromosome in situ hybridization technology, and each method has its own disadvantages and advantages. OBJECTIVE: To observe the transplantation conditions of hepatic stem cells (hepatic oval cells) in the liver graft by Y-chromosome in situ hybridization technology. METHODS: Rat orthotropic liver transplantation models were established by using Kamada two-cuff technique. Female DA rats served as donors, and 60 female Lewis rats were used as recipients. Hepatic oval cells was originated from male Lewis rats and implanted to the liver graft during liver transplantation. Y-chromosome in situ hybridization technology was used to detect hepatic stem cells transplantation conditions in the liver graft. RESULTS AND CONCLUSION: Hepatic oval cells and differentiated cells mainly distributed around central vein area and portal area in the liver graft. The transplantation conditions of recipient derived hepatic stem cells in the liver graft were effectively detected by Y-chromosome in situ hybridization technology. Related Articles | Metrics

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Monitoring the blood concentration of mycophenolic acid in renal transplantation Wang Qing-hua, Shang Le-le, Chen Jin-hua, Wang Jin, Tang Min-ying, Wu Lin, Yang Shun-liang, Tan Jian-ming 2012, 16 (53):  9887-9892.  doi: 10.3969/j.issn.2095-4344.2012.53.002 Abstract ( 537 )   PDF (430KB) ( 951 )   Save BACKGROUND: As an immunosuppressant of anti-metabolites, mycophenolic acid has been widely used in organ transplantation due to its relatively low toxicity. However, its pharmacokinetic properties are unclear when combined with other immunosuppressants such as calcineurin inhibitors (tacrolimus or cyclosporine A). OBJECTIVE: To explore the optimal concentration of mycophenolic acid by dynamically monitoring its concentration in renal transplantation recipients, comparing the pharmacokinetic properties of mycophenolic acid when combined with other immunosuppressants, in order to guide personalized medicine, thereby improving the therapeutic effect and reducing adverse effects. METHODS: The concentration of mycophenolic acid in the blood before drug administration (C0), 0.5 hour after drug administration (C0.5), and 2 hours after drug administration (C2) in the kidney recipients was determined using SyvaEmit-2000 drug concentration detection analyzer. RESULTS AND CONCLUSION: Total 820 mycophenolic acid area under the concentration time curve values were determined from 340 recipients, among which 574 mycophenolic acid area under the concentration time curve values were determined from the recipients received mycophenolate mofetil+tacrolimus and 246 from the recipients received mycophenolate mofetil+cyclosporine A respectively. In mycophenolate mofetil+cyclosporine A, the value of mycophenolic acid area under the concentration time curve was significantly lower than that in the mycophenolate mofetil+tacrolimus group, and the difference was significant (P < 0.05). The concentration of mycophenolic acid at C0 and C0.5 in the mycophenolate mofetil+tacrolimus group was higher than that in the mycophenolate mofetil+cyclosporine A group (P < 0.05), and concentration of mycophenolic acid at C2 in the mycophenolate mofetil+cyclosporine A group was higher than that in the mycophenolate mofetil+tacrolimus group (P < 0.05). Furthermore, in mycophenolate mofetil+tacrolimus group, more patients reached their peak concentration of mycophenolic acid at C0.5. The results indicated that when mycophenolate mofetil was used in combination with other immunosuppressants, the drug administration should be based on their pharmacokinetics properties and the patients might be given a lower dose of mycophenolate mofetil. Three-point mycophenolate mofetil area under the concentration-time curve method for monitoring mycophenolic acid blood concentration was simple and convenient, and could meet the needs for the clinical use. Related Articles | Metrics

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Relationship between acute rejection and expression of serum cytokines before and after renal transplantation Song Jie, Zhang Xiao-dong, Li Ying, Li Hui 2012, 16 (53):  9893-9897.  doi: 10.3969/j.issn.2095-4344.2012.53.003 Abstract ( 300 )   PDF (418KB) ( 647 )   Save BACKGROUND: At present, there are many reports on the changes of cytokines after allogenic organ transplantation, but the reports on the dynamic expression of cytokines in renal transplantation patients and the relationship with acute rejection after renal transplantation are rare. OBJECTIVE: To observe the changes of serum cytokines expression before and after renal transplantation and to investigate the relationship with acute rejection. METHODS: Forty-eight renal transplantation recipients were chosen from the Affiliate Hospital of Logistics College of the Chinese People’s Armed Police Forces during September 2008 to September 2011, and all the patients were in the first renal transplantation. The patients were divided into acute rejection group and stable renal function group. Another 30 health people were selected as control group. RESULTS AND CONCLUSION: There was no significant difference in serum levels of tumor necrosis factor-α, interleukin 6 and interleukin 8 between the stable renal function group, acute rejection group and the control group at 1 day after renal transplantation (P > 0.05). The serum levels of tumor necrosis factor-α, interleukin 6 and interleukin 8 in the stable renal function group were gradually increased at 1 day after renal transplantation, significantly increased at 3 days after transplantation (P < 0.05); then began to decrease at 5 days after transplantation, significantly decreased at 7 days after transplantation (P < 0.05), and decreased to the pre-transplantation point at 14 days. The serum levels of tumor necrosis factor-α, interleukin 6 and interleukin 8 in the stable renal function group were kept in the levels before transplantation from 21 days to 28 days. In the acute rejection group, the serum levels of tumor necrosis factor-α, interleukin 6 and interleukin 8 were increased significantly at 1 day after transplantation (P < 0.05), kept the high levels from 7 days to 14 days (P < 0.05), then decreased from 21 days to 28 days, but the levels were significantly higher than those before transplantation (P < 0.05). At the same time point, the serum levels of tumor necrosis factor-α, interleukin 6 and interleukin 8 in the acute rejection group were significantly higher than those in the stable renal function group (P < 0.05). The dynamic expression of serum tumor necrosis factor-α, interleukin 6 and interleukin 8 can estimate the immune function of renal transplantation recipients and can be used as the immunobiology indicators for the early diagnosis of acute rejection after renal transplantation. Related Articles | Metrics

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Protective effect of gdolinium chloride against ischemia-reperfusion injury to the transplanted liver Quan Hu, He Zhi-jun, Zuo Chao-hui, Ouyang Yong-zhong, Xu Mi, Tang Ming, Tang Wei, Wang Yi-chun 2012, 16 (53):  9898-9902.  doi: 10.3969/j.issn.2095-4344.2012.53.004 Abstract ( 322 )   PDF (534KB) ( 743 )   Save BACKGROUND: Gadolinium chloride can inhibit the Kupffer cell activation, reduce their phagocytic activity, and reduce tumor necrosis factor alpha and interleukin 1 release after Kupffer cell activation, thereby alleviate the ischemia-reperfusion injury of liver. OBJECTIVE: To study the effect of gdolinium chloride on ischemia-reperfusion injury of rat receptor’s liver and to explore the mechanism. METHODS: Donors and receptors were all male Sprague Dawley rats which were randomly divided into three groups. The modified Kamada’s two-cuff technique was used to build rat liver transplantation model through liver superior and inferior vena cava reconstruction by modified continuous suture. In the sham-operation group, the rats were treated without liver transplantation, the liver was freed and the abdomen was closed after vein ligation without treatment and received drug administration. In the saline group, the warm ischemia time was 0-5 minutes and cold preservation time of the donor liver was 2 hours, the saline was injected into the rats via the tail vein for 3 days before implantation, and after implantation, the saline was injected into the rats once more. In the gadolinium chloride group, the warm ischemia time was 0-5 minutes and cold preservation time of the donor liver was 2 hours, 0.5% gadolinium chloride was injected into the rats via the tail vein for 3 days before implantation, and after implantation, the injection was performed once more. The rats were sacrificed after 24 hours for the corresponding index detection. RESULTS AND CONCLUSION: Compared with sham-operation group, the serum alanine aminotransferase, alanine aminotransferase, alkaline phosphatase and γ-gamma-glutamyl transferase levels were increased significantly in gadolinium chloride and saline groups (P < 0.05); all the indexes in gadolinium chloride group were decreased compared with saline group (P < 0.05). In pathologic histology tests, the lesion range and the extent of ischemia-reperfusion injury were all significantly increased in saline group and gadolinium chloride group. Compared with the saline group, the concentrations of interleukin-1, tumor necrosis factor-α and the apoptosis index were decreased significantly in gadolinium chloride group (P < 0.05), as well as the congestion, vacuolar degeneration and Suzuki’s score (P < 0.05). The protective effect of gdolinium chloride on ischemia-reperfusion injury of receptor’s liver might result from closing the Kupffer cells and reducing cytokine release. Related Articles | Metrics

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Severe pneumonia after renal transplantation Li Li-hua, Yu Hong-tao, Jia Jin-guang, Wang Min, Du Juan 2012, 16 (53):  9903-9910.  doi: 10.3969/j.issn.2095-4344.2012.53.005 Abstract ( 317 )   PDF (636KB) ( 649 )   Save BACKGROUND: The incidence rate and the mortality of severe pneumonia after renal transplantation are high. So it has great significance to early diagnosis and treatment of severe pneumonia. OBJECTIVE: To analyze the clinical characteristics, pathogenetic condition and prognosis of severe pneumonia patients after renal transplantation treated in respiratory intensive care unit, in order to improve the early diagnosis rate and cure rate. METHODS: Twenty-eight severe pneumonia patients after renal transplantation treated in the respiratory intensive care unit of Zhengzhou People’s Hospital from January 2004 to September 2012 were investigated retrospectively, and the characteristics were summarized. The pathogenetic condition of the patients was evaluated with Acute Physiology and Chronic Health Evaluation Ⅱ and British Thoracic Society Modified Pneumonia score CURB-65, and the patients were treated appropriately. RESULTS AND CONCLUSION: The severe pneumonia infection in 28 patients occurred at 3-8 months after renal transplantation and most of the patients received larger immunosuppressant doses. The patients complaint of tachypnea, dry cough, chest tightness and fever. The plasma albumin of the severe pneumonia patients was significantly decreased; the arterial blood gas analysis showed the hypoxemia and low hypercapnia, and the arterial oxygen saturation was gradually decreased. Chest CT showed that there was shadow secretion in the lung. Then the patients disable the immunosuppressive drugs, combined with anti-infection treatment and non-invasive ventilator, finding that 24 patients were cured, two patients were improved and two patients were dead. The liver function and renal function of patients were progression-free during treatment. Excessive immunosuppression after renal transplantation is the risk factor for severe pneumonia; great importance to the monitoring the body temperature after the event, shortness of breath and unexplained serum albumin decreasing are benefit to the early diagnosis. Decisively disable the immunosuppressive drugs combined with the broad-spectrum anti-infective drugs, methyl prednisolone and non-invasive ventilation therapy are the key to the successful treatment. Related Articles | Metrics

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Variation of tacrolimus trough levels in renal transplant recipients during acute diarrhea Feng Xiao-fang, Wang Li-ming, Min Min, Zuo Fu-jie, Zhou Mei-sheng 2012, 16 (53):  9911-9915.  doi: 10.3969/j.issn.2095-4344.2012.53.006 Abstract ( 962 )   PDF (397KB) ( 760 )   Save BACKGROUND: For a long time, the organ transplant workers pay more attentions to the intestinal adverse effects of mycophenolate mofetil; however, the relationship between tacrolimus and diarrhea has not attracted much attention. OBJECTIVE: To observe the change of tacrolimus trough levels and treatment efficacy in renal transplant recipients during of acute diarrhea. METHODS: Ninety cases with acute diarrhea were observed after renal transplantation, tacrolimus+mycophnolate mofetil+prednisone triple immunosuppressive regimen was used to detect the tacrolimus rough levels and related etiological laboratory before, during and after acute diarrhea. Among 72 cases with increased tacrolimus trough levels, 48 cases with negative etiological examination were randomly divided into two groups: group A (n=24) and group B (n=24). The patients in group A only reduced the dose of tacrolimus in the course of the treatment and the patients in group B reduced the dose of tacrolimus and mycophnolate mofetil. We observed the efficacy and duration time of tacrolimus trough levels elevated. RESULTS AND CONCLUSION: There was no significant difference in the efficacy and the duration time of tacrolimus trough levels elevated between two groups. Diarrhea following kidney transplantation could significantly result in abnormally elevation of tacrolimus trough levels. We should reduce the dose of tacrolimus and increase the monitoring frequency of tacrolimus trough levels during diarrhea, which can reduce the incidence of adverse effects; in the course of the treatment, we should not to reduce the dose of mycophnolate mofetil, as it can increase the incidence of rejection rate. Related Articles | Metrics

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Early diagnosis of BK virus associated nephropathy after renal transplantation Han Yong, Cai Ming, Qian Ye-yong, Wang Xin-ying, Huang Hai-yan, Xu Xiao-guang, Xiao Li, Zhou Wen-qiang, Feng Kai, Shi Bing-yi 2012, 16 (53):  9916-9920.  doi: 10.3969/j.issn.2095-4344.2012.53.007 Abstract ( 429 )   PDF (554KB) ( 780 )   Save BACKGROUND: Combination detection has clinical values in the early diagnosis of BK virus associated nephropathy (BKVAN) after renal transplantation. But the studies on it are rare. OBJECTIVE: To establish the combination detection method for BKVAN after renal transplantation, and to discuss the pathological features and clinical characteristics of BKVAN. METHODS: Peripheral blood and urine samples of 84 renal transplantation recipients were selected. A variety of methods were used in this study that comprised the quantitative real-time PCR method of detecting BK viral load in both urine and serum samples, the Papanicolaou staining for urine bait cells, pathologically biopsy and immunohistochemistry approach for renal biopsy tissues. All the methods were used for the early diagnosis of BKVAN. RSSULTS AND CONCLUSION: Two patients were diagnosed with BKVAN, accounting for 2.5% of the renal allograft participants. The renal function of the two confirmed BKVAN patients improved significantly following the reduction of immunosuppressive agents. The combined detection methods can improve the diagnosis of BKVAN with higher accuracy, feasibility and paved the way for further research about the relationship between the BKV pathogen infection and the loss of renal allografts. Related Articles | Metrics

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Low-dose cyclosporine A reduces sirolimus-associated proteinuria after kidney transplantation Liu Jun-duo, Song Wen-li 2012, 16 (53):  9921-9924.  doi: 10.3969/j.issn.2095-4344.2012.53.008 Abstract ( 327 )   PDF (386KB) ( 606 )   Save BACKGROUND: Sirolimus has been proposed as a non-nephrotoxic alternative to calcineurin inhibitor for prevention of adverse reaction after kidney transplantation, proteinuria is one of the most significant adverse reactions. So far, there is no effective treatment measure, and it limits the use of this molecule. OBJECTIVE: To investigate the efficacy and safety of low-dose cyclosporine A in reducing the sirolimus-associated proteinuria after kidney transplantation. METHODS: This prospective study included 24 kidney transplant recipients who receiving sirolimus based tri-regimens immunosuppressed therapy (sirolimus+mycophenolate mofetil+cotical hormone) and suffering sirolimus-associated proteinuria. Low-dose cyclosporine (25 mg/d) was added to the tri-regimens immunosuppression in 10 recipients (tetra-regimens group), and the other 14 patients maintained the tri-regimens immonusuppression (tri-regimens group). All the patients were followed-up for 6 months. RESULTS AND CONCLUSION: ①After 6 months follow-up, the content of proteinuria in the tetra-regimens group was significantly decreased (P < 0.01), and the difference was significant when compared with tri-regimens group (P < 0.05). ②There was no significant difference of the glomerular filtration rate between two groups (P=0.10). There were three patients suffering from genitourinary tract infection in tri-regimens group, while three patients in tetra-regimens group suffered from six infectious episodes, one patient suffered from lung infection and five patients suffered from genitourinary tract infection. Low-dose cyclosporine can reduce sirolimus-associated proteinuria after kidney transplantation without serious nephrotoxicity and infectious side effects. Related Articles | Metrics

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Relationship between microchimerism and acute rejection after spouse donor kidney transplantation Kang Yun-kai, Guo Juan, Yuan Cai-hong, Qi Ying-ying, Li Hong-juan, Han Hong-peng 2012, 16 (53):  9925-9*928.  doi: 10.3969/j.issn.2095-4344.2012.53.009 Abstract ( 333 )   PDF (418KB) ( 722 )   Save BACKGROUND: Microchimerism as the sign of biphasic cell migration between the graft and the recipient has attracted more and more attention in transplantation tolerance. OBJECTIVE: To investigate the relationship between spousal life and occurrence of chimerism and the acute rejection after renal transplantation. METHODS: The female kidney transplant recipients (except the females have reproductive history) were divided into two groups: husband living kidney donation group and unrelated male cadaver kidney donation group. Control group was set for husband recipients who received the living kidney donation of their wives. The Y chromosome from the male donor in the female recipients was detected by STR to reflect the presence of microchimerism as well as the correlation with acute rejection. The effect of the donor kidney was compared between spouses. RESULTS AND CONCLUSION: Though there was a higher rate of human leukocyte antigen mismatches and elder donor age between spouses, the female recipients received husband living kidney donation detected the microchimerism more easily when compared with the female recipients received unrelated male cadaver kidney donation, and female recipients received husband living kidney donation could recover quickly with lower acute rejection rate. Compared with the husband received wife living kidney donation, the wife received husband living kidney donation had better effect after renal transplantation. It indicates that long terms of spousal life leads to more opportunity of accepting her husband’s humoral, so result in the immune tolerance with good kidney compatibility after renal transplantation and low acute rejection rates. Related Articles | Metrics

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One case of severe pneumocystis carinii pneumonia after renal transplantation Wang Xu-zhen, Xue Wu-jun, Tian Pu-xun, Ding Xiao-ming, Feng Xin-shun, Hou Jun, Tian Xiao-hui 2012, 16 (53):  9929-9933.  doi: 10.3969/j.issn.2095-4344.2012.53.010 Abstract ( 320 )   PDF (453KB) ( 643 )   Save BACKGROUND: Pneumocystis carinii pneumonia is a serious complication after renal transplantation. It is rare and onset is insidious. A typical clinical symptoms, rapid progression and high mortality are observerd in this desease. OBJECTIVE: To investigate the clinical features, treatment and prevention methods of pneumocystis carinii pneumonia after renal transplantation. METHODS: The clinical data of one case of severe pneumocystis carinii pneumonia after renal transplantation that selected from the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine were retrospectively analyzed. RESULTS AND CONCLUSION: A 62-year-old female kidney transplantation recipient suffered from fever and progressive hypoxemia at 100 days after the transplantation. Pneumocystis carinii pneumonia was detected by bronchoscopy and alveolar biopsy. Through compound sulfamethoxazole and trimethoprim tablets administration, mechanical ventilation and other supportive treatment, the patient was cured. Prevention is particularly important in pneumocystis carinii pneumonia because the rapid progression and high mortality. Bronchoscopy should be carried out early in the patients with risk factors especially those have presented clinical symptoms such as fever and hypoxemia. Immunosuppressive agents should be adjusted carefully in the course of treatment of pneumocystis carinii pneumonia. The ratio of CD4+/CD8+ may be a useful index to the adjustment of immunosuppressive agents. Related Articles | Metrics

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Immune tolerance of rat liver transplantation induced by pre-infusion of RNA interference RelB short hairpin RNA lentiviral modified dendritic cells Xie Jin-min, Wang Yan, Bao Jie, Ma Yong-ge, Zou Zhi-hao, Tang Zeng-jie, Dong Rui-qiang, Wen Hao 2012, 16 (53):  9934-9940.  doi: 10.3969/j.issn.2095-4344.2012.53.011 Abstract ( 343 )   PDF (629KB) ( 541 )   Save BACKGROUND: Homograft rejection is the most important factor that limits the survival of recipients and donor organs fter liver transplantation. Induced specific immune tolerance is a most satisfactory method to release rejection after transplantation. OBJECTIVE: To explore the possibility of the specific immune tolerance induced by RNA interference RelB dendritic cells pre-infusion after liver transplantation in rats. METHODS: A stable rat model of acute rejection was established by allograft liver transplantation from DA (RT1a) rats to Lewis (RT11) rats. Before transplantation, the donor and recipient rats were paired and randomly divided into four groups: (1)Control group: the recipient rats were not injected before liver transplantation. (2)RNA interference RelB treatment group: the recipient rats were pre-injected with RNA interference RelB dendritic cells from donor (5×106) via veins at the 7 days before transplantation. (3)Immature dendritic cells group: the recipient rats were pre-injected with immature dendritic cells (5×106) from donor via veins at the 7 days before transplantation. (4)Mature dendritic cells group: the recipient rats were pre-injected with mature dendritic cells (5×106) from donor via veins at the 7 days before transplantation. RESULTS AND CONCLUSION: Compared with control group, immature dendritic cells group and mature dendritic cells group, the average survival time of graft renal in RNA interference RelB treatment group prolonged significantly (P < 0.01). The content of aspartate aminotransferase and total bilirubin in RNA interference RelB treatment group at 7 days after transplantation were significantly lower that those in the control group, immature dendritic cells group and mature dendritic cells group (P < 0.01), while the content of aspartate aminotransferase and total bilirubin at 14 days after transplantation in RNA interference RelB treatment group and immature dendritic cells group were slightly decreased, and there was significant difference between two groups (P < 0.01). At 7 days after transplantation, compared with RNA interference RelB treatment group, the contents of interferon-γ and interleukin-2 were increased in the control group, immature dendritic cells group and mature dendritic cells group (P < 0.01), while the contents of interleukin-4 and interleukin-10 were decreased (P < 0.01); at 14 days after transplantation, the contents of interferon-γ and interleukin-2 were decreased and the contents of interleukin-4 and interleukin-10 were increased in RNA interference RelB treatment group and immature dendritic cells group, and there was significant difference between two groups (P < 0.01). At 7 days after transplantation, the rejection active index in the control group, immature dendritic cells group and mature dendritic cells group was 8.0-9.0. At 14 days after transplantation, more necrosis of hepatocytes and endotheliocyte and inflammatory cells imbibition in header zone were observed in immature dendritic cells group. The rejection active index in RNA interference RelB treatment group at 7 days after transplantation was 6.0-8.0, and rejection active index was 4.0-5.0 at 14 days after transplantation. Pre-injection of RNA interference RelB dendritic cells may contribute to reduce the degree of graft rejection and prolong the survival time of grafted liver, which related to the regulation and immune-incompetent of T cells. Related Articles | Metrics

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Clinical analysis of the artificial ventilation in 50 recipients after liver transplantation Luo Xian-rong, Liu Shu-ren, Zeng Guo-bing, Luo Li-min 2012, 16 (53):  9941-9945.  doi: 10.3969/j.issn.2095-4344.2012.53.012 Abstract ( 270 )   PDF (431KB) ( 602 )   Save BACKGROUND: Artificial ventilation is a necessary stage after liver transplantation which is correlated with a variety of factors OBJECTIVE: To explore the influential factors for artificial ventilations after liver transplantation. METHODS: The correlations between the durations of artificial ventilations and the preoperative complications, intraoperative oxygen metabolisms, postoperative liver and kidney functions, and the blood gas and electrolyte levels were retrospectively assessed. RESULTS AND CONCLUSION: The durations of artificial ventilations were implicated in the preoperative complications, intraoperative oxygen metabolisms and postoperative liver and kidney functions (P < 0.05), but the blood gas and electrolyte levels to the contrary (P > 0.05). The preoperative complications, intraoperative oxygen metabolisms and postoperative liver and kidney functions can influence the durations of artificial ventilations of the recipients. Related Articles | Metrics

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Significance of bone marrow cytology during perioperative period of orthotopic liver transplantation Zhao Yi-wen, Cui Juan-hong, Song Li-jie, Yao Gui-ling 2012, 16 (53):  9946-9950.  doi: 10.3969/j.issn.2095-4344.2012.53.013 Abstract ( 277 )   PDF (439KB) ( 597 )   Save BACKGROUND: The reports on the advanced liver disease and liver transplantation hematopoietic system which affected are rare. OBJECTIVE: To study the characteristics of hematopoiesis function before orthotopic liver transplantation and the effects of a series of post-operation complications on hematopoiesis function of the bone marrow after orthotopic liver transplantation by observing bone marrow cytology. METHODS: Bone marrow cytology was analyzed in 20 cases of orthotopic liver transplantation. Due to the relationship with hematological diseases, bone marrow cytology examination was needed to be performed to diagnosis and differential diagnosis. Two cases received the examination before transplantation and 18 cases received the examination after transplantation. RESULTS AND CONCLUSION: Hypersplenism and macrocytic anemia could be seen in the patients with orthotopic liver transplantation before transplantation. Graft versus host disease, plasma cell leukemia, leukemoid reaction, idiopathic thrombocytopenic purpura, hemophagocytic syndrome, metastatic hepatic carcinoma, agranulocytosis, acute hematopoietic cells stagnation and reactive thrombocytosis were shown after transplantation. Monitoring the effect of various complications in the perioperative period of liver transplantation on bone marrow hematopoietic function through bone marrow cytology examination has important significance for the treatment of patients with graft versus host disease. Related Articles | Metrics

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Establishment of a rat lung transplantation model with non-heart beating donor Ji Yong, Chen Jing-yu, Zheng Ming-feng, Ye Shu-gao, Wu Xiao-bo, Wu Bo, Liu Feng 2012, 16 (53):  9951-9954.  doi: 10.3969/j.issn.2095-4344.2012.53.014 Abstract ( 329 )   PDF (385KB) ( 721 )   Save BACKGROUND: A large number of experiments have shown that the donor lung tissue and pulmonary vascular function can be stored under appropriate conditions. When the donor heart beating stops, the pulmonary gas exchange system can be tolerant to the warm ischemia for 60 minutes. OBJECTIVE: To establish a simple and effective rat lung transplantation model with non-heart beating donor. METHODS: Sixty Sprague-Dawley rats were randomly divided into heart beating donor group, non-heart beating donor-ischemia 30 minutes group and non-heart beating donor-ischemia 60 minutes group, there were 20 rats in each group. The lungs of the donor rats in the heart beating donor group were obtained and stored in 4 ℃ low potassium dextran solution for 4 hours; rats in the non-heart beating donor-ischemia 30 minutes group were bloodletting sacrificed, and the lungs of the rats were maintained ventilation for 30 minutes, and then performed with cold preservation after hot ischemia for 30 minutes; the treatment method in the non-heart beating donor-ischemia 60 minutes group was similar to that in the heart beating donor-ischemia 30 minutes group, the difference was that the time of hot ischemia. The peak airway pressure and pulmonary venous blood oxygen partial pressure was measured at 1, 15, 30, 45 and 60 minutes after the connection of the circulation loop in each group. After perfusion, the wet weight and dry weight ratio and the malondialdehyde level were detected. RESULTS AND CONCLUSION: There was no significant difference of all the indexes between heart beating donor group and non-heart beating donor-ischemia 30 minutes group (P > 0.05). The peak airway pressure in each group was increased gradually along with the extension of time, but the peak airway pressure in non-heart beating donor-ischemia 60 minutes group was higher than that in the heart beating donor group and non-heart beating donor-ischemia 30 minutes group (P < 0.05). The pulmonary blood oxygen partial pressure in each group was gradually decreased with the extension of time, and the pulmonary blood oxygen partial pressure non-heart beating donor-ischemia 60 minutes group was lower than that in heart beating donor group and non-heart beating donor-ischemia 30 minutes group (P < 0.05). The wet/dry weight ratio and the malondialdehyde level in non-heart beating donor-ischemia 60 minutes group were higher than those in heart beating donor group and non-heart beating donor-ischemia 30 minutes group (P < 0.05). Non-heart beating donor-ischemia 30 minutes is a safe and effective method for lung transplantation. Related Articles | Metrics

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Blood glucose control in the perioperative stage of cardiac value replacement influences levels of blood lactic acid Qu Chuan-zheng, Zhang Rui-ying, Xiang Kai-fang 2012, 16 (53):  9955-9959.  doi: 10.3969/j.issn.2095-4344.2012.53.015 Abstract ( 347 )   PDF (423KB) ( 699 )   Save BACKGROUND: Hyperglycemia after cardiac-valve replacement can happen easily that is unfavorable on the prognosis. However, the perioperative blood glucose has close relationship with the level of lactic acid in patients. OBJECTIVE: To observe the changes of blood glucose and blood lactic acid levels in the patients with cardiac-valve replacement, and to perform the correlation analysis. METHODS: Sixty-three patients with cardiac-valve replacement were randomly divided into two groups. The control group received traditional standard therapy, and the blood glucose concentration was maintained at 7.5-11.1 mmol/L. The experimental group received intensive therapy by subcutaneous infusion or continuous insulin infusion, and the blood glucose concentration was maintained at 3.6-7.5 mmol/L. RESULTS AND CONCLUSION: The concentration of blood glucose during cardiopulmonary bypass and after valve replacement in experimental group was lower than that in the control group (P < 0.05); with the time of the cardiac-valve replacement increased, the blood lactic acid levels of two groups were significantly increased, and the hyperlactacidemia could be seen, the incidence of complications in the experimental group was lower than that in the control group (P < 0.05). The blood glucose and blood lactic acid levels in two groups were gradually increased and returned to the normal levels, the blood glucose and blood lactic acid levels were highest at 6 hours after replacement. The changes of blood glucose level and blood lactic acid level were the same. One variant linear regression analysis showed the correlation coefficient of blood glucose and lactic acid was 0.838 and P < 0.01 in one side, which proved that there was a linear relationship between the two variables. Strict application of insulin is beneficial to the control intraoperative and postoperative blood glucose and blood lactic acid levels of cardiac-valve replacement and can reduce the incidence of complication after replacement. Perioperative blood glucose and blood lactic acid levels are positively correlated. Related Articles | Metrics

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Expression of transforming growth factor-beta 1 in intestinal graft intervened by cyclosporine A Jin Xiao-shi, Jiao Zheng-wei, Zhang Ai-min, Cheng Shu-jie, Liu Tong, Wang Peng-zhi 2012, 16 (53):  9960-9964.  doi: 10.3969/j.issn.2095-4344.2012.53.016 Abstract ( 285 )   PDF (509KB) ( 540 )   Save BACKGROUND: The chronic rejection of intestinal graft is the important factor affecting the long term prognosis. OBJECTIVE: To observe the effect of cyclosporine A on the expression of transforming growth factor-β1 in intestinal graft in rats. METHODS: Allogeneic small intestine transplantation was performed in rats by microsurgical technology with the donor of F344(RT11vr) rats and the recipient of Lewis(RT11) rats. The graft biopsy and routine pathologic examination were performed at 7, 28 and 60 days after modeling. mRNA transcription level of transforming growth factor-β1 was detected by real time-PCR. Immunohistochemical staining was also performed to detect the expression of transforming growth factor-β1. RESULTS AND CONCLUSION: The mRNA transcription level of transforming growth factor-β1 was significantly decreased during the application of cyclosporine A at 7-28 days after modeling. At 28-60 days after modeling, the mRNA transcription level was significantly increased after termination of cyclosporine A. Cyclosporine A can inhibit the expression of transforming growth factor-β1 in allogeneic small intestine transplantation. Related Articles | Metrics

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Mouse endometrial stromal cells: Isolation, culture, identification and induced decidualization in vitro Zhang Peng, Zhong Ting, Tang Min, Zhang Bao-ping, Kuang Hai-bin 2012, 16 (53):  9965-9969.  doi: 10.3969/j.issn.2095-4344.2012.53.017 Abstract ( 684 )   PDF (506KB) ( 1252 )   Save BACKGROUND: A lot of methods about the isolation, culture and induced decidualization in vitro of endometrial stromal cells have been established in China, but there is a problem about drawn difficulties of uterine specimens. OBJECTIVE: To establish the method of isolation, culture and induced decidualization in vitro of mouse endometrial stromal cells, and to provide a simple and effective model for further study about the mechanism of endometrial decidualization. METHODS: The trypsin and collagenase Ⅱ digestion and pasted wall were used to isolate and purify endometrial stromal cells of the mouse that pregnancy for 4 days; stromal cells were identified by immunocytochemistry; endometrial stromal cells treated by estradiol and progesterone were induced the decidualization, and the decidual markers were checked by hematoxylin nuclear staining, real-time quantitative PCR and western blot. RESULTS AND CONCLUSION: The survival rate of endometrial stromal cells was (90.1± 2.3)%. Immunocytochemistry staining results showed that separated and purified uterine stromal cells were stained positive with Vimentin, and negative with Cytokeratin, the purities of cells were (92.3±2.4)%. Hematoxylin staining showed that endometrial stromal cells were multinucleated after treated with estradiol and progesterone for 48 and 72 hours. The decidualization prolactin-related protein, cyclin D3, progesterone receptor mRNA of decidual markers were significantly increased with the incubation time prolonged (P < 0.05). Highly purified stromal cells of endometrium can be obtained by enzymolysis and pasted wall purification. Endometrial stromal cells treated by estradiol and progesterone can be induced to the decidualization in vitro. Related Articles | Metrics

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Hearing results following the tragus cartilage ring with perichondrium in myringoplasty Liu Xiong-guang, Zhou Qing, Huang Shao-wei, Hong Yuan-geng, Peng Ding-jun, Yao Li-ping, Zhang Xiao-yan 2012, 16 (53):  9970-9974.  doi: 10.3969/j.issn.2095-4344.2012.53.018 Abstract ( 407 )   PDF (466KB) ( 632 )   Save BACKGROUND: At present, there is still lack of a valid valuation system for evaluating chronic maturation treatment effect and subjective hearing improvement is the most important criteria to judge the success of myringoplasty. OBJECTIVE: To evaluate the hearing results following the tragus cartilage ring with perichondrium in myringoplasty and to analyze the related impact factors. METHODS: A total of 240 patients treated with tragus cartilage ring with perichondrium in myringoplasty were selected and followed-up for 3 years, then the eardrum growth was tracking observed and the pure tone threshold checking was performed, and then the hearing improvement was daily recorded. Multiple linear regression analysis was performed on 10 factors that may affect the efficacy. RESULTS AND CONCLUSION: Multiple linear regression statistical analysis was subsequently carried out on these prognostic factors of hearing outcomes and yielded the following relative importance of predictive as follows; mean preoperative air conduction threshold, duration of dry ear, duration of disease and age. The subjective hearing changes were correlated with the objective hearing changes. Comparing the preoperative airbone gap and the postoperative subjective hearing ability, we found that the subjective hearing ability of 83.3% patients was significantly improved; comparison between preoperative air conduction threshold and postoperative subjective hearing ability showed that the subjective hearing ability of about 83.9% patients were significantly improved. Among the patients with decreased air conduction threshold less than 10 dB, the subjective hearing of 54.5% patients was improved; and when the air conduction threshold decreased more than 30 dB, the subjective hearing of 97.8% patients was improved. It suggests that the improvement degree of the subjective hearing is positively correlated with the decreasing degree of the air conduction threshold after myringoplasty, the more the air conduction threshold decreased, the more the subjective hearing improved. Related Articles | Metrics

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Transplantation of single-bundle four-strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction Xu Chang-ming, Yang Le, Hu Yu-hua, Huangfu Xiao-qiao 2012, 16 (53):  9975-9979.  doi: 10.3969/j.issn.2095-4344.2012.53.019 Abstract ( 321 )   PDF (458KB) ( 570 )   Save BACKGROUND: There are rare clinical reports addressing the establishment of the anterior cruciate ligament femoral tunnel through the anteromedial approach. OBJECTIVE: To explore the feasibility of arthroscopic single-bundle four-strand hamstring tendon for anterior cruciate ligament reconstruction through the anteromedial approach. METHODS: Sixty-five patients who underwent anterior cruciate ligament reconstruction were randomly divided into two groups. Thirty-five patients accepted single-bundle four strands hamstring tendon anterior cruciate ligament reconstruction via anteromedial approach and 30 patients accepted single-bundle four strands hamstring tendon anterior cruciate ligament reconstruction through transtibial drilling technique. The average follow-up was 16 months. Anteroposterior stability, rotational stability and overall function of the knee were assessed. RESULTS AND CONCLUSION: At the final follow-up, there was no significant difference in the anteroposterior stability and Lysholm score between transtibial drilling group and anteromedial approach group (P > 0.05). The positive rate of the pivot-shift test was 23% in transtibial drilling group and 6% in anteromedial approach group, and there was a significant difference between two groups (P < 0.05). Both anteroposterior stability and rotational stability of the knee were reconstructed by single-bundle anterior cruciate ligament reconstruction via the anteromedial approach. Related Articles | Metrics

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Changes of Toll like receptors in the reaction of recombinant human interleukin-10 resisting rabbit skin grafting Lü Yan-yan, Sun Wan-bang, Li Jia, Dai Xiao-bo, Zhang Lei, Wang Sheng-xiang, Chen Fu-chao, Luo Jun-min 2012, 16 (53):  9980-9986.  doi: 10.3969/j.issn.2095-4344.2012.53.020 Abstract ( 310 )   PDF (500KB) ( 670 )   Save BACKGROUND: The researchers have recognized that there is a very close relationship between the activation of the Toll-like receptors and organ transplant rejection, and the Toll-like receptors and transplantation immunology have gradually become a hot topic. OBJECTIVE: To observe the changes of Toll-like receptors in the serum drawing from rabbits treated with recombinant human interleukin-10 after allogeneic skin grafting. METHODS: The rabbit back defect models were prepared, and the receptor rabbits were divided into six groups: low dose recombinant human interleukin-10 group, high dose recombinant human interleukin-10 group, low dose cyclosporine A group, high dose cyclosporine A group, joint group and normal saline group. The 5 and 10 μg/(kg•d) recombinant human interleukin-10, 5 and 10 mg/(kg•d) cyclosporine A, 5 μg recombinant human interleukin-10+5 mg cyclosporine A and 1 mL/d normal saline were injected into the rabbits respectively from 1 day before grafting and lasted for 10 days. RESULTS AND CONCLUSION: The levels of serums Toll-like receptor 4, Toll-like receptor 7, Toll-like receptor 8 and Toll-like receptor 9 were increased after skin grafting compared with that before grafting and reached to the peak concentration on 14 days. At 4 and 7 days after grafting, the level of Toll-like receptors 4 in the normal saline group was higher than that in the joint group (P < 0.05). At 7 days after grafting, the level of Toll-like receptor 7 in the normal saline group was higher than that in the other five groups (P < 0.05), and the level of Toll-like receptor 8 in the normal saline group was higher than that in the high dose cyclosporine A group (P < 0.05). There was no significant difference of Toll-like receptor 9 level in each two groups at different time points after grafting (P > 0.05). The levels of serum Toll-like receptor 4, Toll-like receptor 7, Toll-like receptor 8 and Toll-like receptor 9 were increased obviously after the rabbits skin grafting which have treated with recombinant human interleukin-10 resisting skin grafting, and reached to the peak concentration after skin graft rejection, and then decreased gradually, which means Toll-like receptors participate in the allograft rejection. Related Articles | Metrics

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Induction and identification of CD11clowCD45RBhigh regulatory dendritic cells Liu Cang-chun, Huang Yi-hong, Feng Sa-ran, Gu Hong-hong, Zeng Ling-yun, Li De-peng, Xu Kai-lin 2012, 16 (53):  9987-9993.  doi: 10.3969/j.issn.2095-4344.2012.53.021 Abstract ( 444 )   PDF (750KB) ( 505 )   Save BACKGROUND: CD11clowCD45RBhigh regulatory dendritic cells (DCregs) have potential significance in participating the immune negative regulatory mechanism and clinical treatment. But it is still little about the induction and identification of human bone marrow-derived regulatory dendritic cells. OBJECTIVE: To induce the human bone marrow-derived CD11clowCD45RBhigh regulatory dendritic cells and identify them from the aspects of cell morphology, immunological phenotype, the ability of phagocytosis and stimulating T lymphocytes proliferation in vitro. METHODS: Mononuclear cells isolated from human bone marrow cells were induced and cultured with different cytokines in vitro. The cells were divided into three groups: (1)Regulatory dendritic cells group: regulatory dendritic cells were cultured for 7 days in RPMI 1640 culture medium containing granulocyte-macrophage colony-stimulating factor, interleukin-10 and transforming growth factor-β1, then stimulated with lipopolysaccharide for 24 hours. (2)Immature regulatory dendritic cells group: the immature regulatory dendritic cells were cultured for 8 days in RPMI 1640 culture medium containing granulocyte-macrophage colony-stimulating factor and interleukin-4. (3)Mature regulatory dendritic cells group: mature regulatory dendritic cells were cultured for 7 days in RPMI 1640 culture medium containing granulocyte-macrophage colony-stimulating factor and interleukin-4, and then stimulated with lipopolysaccharide for 24 hours to make them mature. The morphological phenotypes were observed under light and scanning microscope, the immunological phenotypes and ability of phagocytes were detected with flow cytometry, and the proliferative capacity of T cells stimulated by different subset of regulatory dendritic cells were examined by the Cell Count Kit-8. RESULTS AND CONCLUSION: Mononuclear cells separated from human bone marrow cells differentiated into a new CD11clowCD45RBhigh subset of regulatory dendritic cells after cultured in the culture medium of RPMI 1640 containing granulocyte-macrophage colony-stimulating factor and interleukin-10 and transforming growth factor-β1 for 8 days, which has the typical morphology and immunological phenotype, and their immunological phenotype and immunological function had the characteristics of immature regulatory dendritic cells. The results showed that our method to culture the regulatory dendritic cells was feasible. The CD11clowCD45RBhigh regulatory dendritic cell is a new subset of dendritic cell, which has the powerful of phagocytosis function and weak ability to stimulate the proliferation of T lymphocytes. Here we establish an experimental basis for the researched on regulatory dendritic cells in immune tolerance. Related Articles | Metrics

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Identification of a novel human leukocyte antigen-DPA1*01:11 allele in a Chinese Han population He Liu-mei, Wang Da-ming, Xu Yun-ping, Deng Zhi-hui 2012, 16 (53):  9994-9998.  doi: 10.3969/j.issn.2095-4344.2012.53.022 Abstract ( 488 )   PDF (414KB) ( 628 )   Save BACKGROUND: In population genetics research, an abnormal loci result of human leukocyte antigen-DPA1 sample was found, while the international reports on the human leukocyte antigen-DPA1 allele are rare. OBJECTIVE: To identify a novel human leukocyte antigen-DPA1*01 variant allele in a Chinese Han individual. METHODS: Sequencing based typing at exon 2 of human leukocyte antigen-APA1 gene in both directions was used in our population genetics study. Samples with in-conclusive results were subjected to molecular cloning and haplotype sequencing. RESULTS AND CONCLUSION: An abnormal loci result of human leukocyte antigen-DPA1 sample was found, and a sample with in-conclusive result in sequencing based typing test subjected to cloning and haplotype sequencing, one normal HLA-DPA1*01:03 allele and a novel DPA1*01 variant allele were identified. The novel DPA1*01 variant allele differs from the closest allele DPA1*01:03 by single nucleotide change at coding sequence nt242 A>G in exon 2, and leading to the corresponding 50 codons CAA> CGA, thus resulted in encoded amino acid residues changed from glutamine into arginine. The identified novel DPA1*01 variant allele has been officially designated as human leukocyte antigen-DPA1*01:11 by World Health Organization Nomenclature Committee for Factors of Human Leukocyte Antigen System (Submit serial number: HWS10015443). Related Articles | Metrics

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Identification of novel human leukocyte antigen alleles: A*11:97 and B*44:127 Hu Bin, Chi Xiao-yun, Feng Zhi-hui 2012, 16 (53):  9999-10004.  doi: 10.3969/j.issn.2095-4344.2012.53.023 Abstract ( 460 )   PDF (373KB) ( 595 )   Save BACKGROUND: In recent years, with the development of molecular biology and the improvement of human leukocyte antigen typing technique, novel allele of human leukocyte antigen has been discovered constantly. OBJECTIVE: To identify and confirm two novel human leukocyte antigen alleles METHODS: The gene typing of human leukocyte antigen A, human leukocyte antigen B and DRB1 site was performed on two samples from the Chinese Bone Marrow Bank with the PCR-SBT, GSSP and single-stranded sequencing genotyping technology, then the DNA sequencing was performed on the new alleles, and the sequence alignment was conducted between the new alleles and the known allele with the highest homology. RESULTS AND CONCLUSION: One of the sequences of two samples was different from the sequence of the allele of human leukocyte antigen A and human leukocyte antigen B. Sample 1 indicated that it differed from the closet matching allele A*11:01:01 in two nucleotide substitutions 193G>T and 194C>T in Exon2 that resulting in amino acid changed from Alanine (Ala) to Leucine (Leu) at codon 41, and sample 2 differed from the closet matching allele B*44:02 in one nucleotide substitution 300G>A in Exon2 that resulting in amino acid changed from Arginine (Arg) to Histidine (His) at codon 83. The novel alleles were identified as human leukocyte antigen A and human leukocyte antigen B and assigned the name of human leukocyte antigen A*11:97 and B*44:127 officially by the WHO Nomenclature Committee. Related Articles | Metrics

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Effect of insulin-like growth factor 1 antagonized high glucose on imprinted gene H19/Igf-2 in mouse preimplantation embryos Luo Wen-qi, Yuan Heng, Wu Chang-chu, Zhao Pin, Li Shuang-rong, Cheng De-hua, Zou Hai-yan 2012, 16 (53):  10005-10009.  doi: 10.3969/j.issn.2095-4344.2012.53.024 Abstract ( 367 )   PDF (467KB) ( 516 )   Save BACKGROUND: The previous studies have confirmed that 100 μg/L insulin-like growth factor 1 can antagonist apoptosis in vitro induced by 30 mmol/L glucose toxicity, it can relieve harm of high glucose on maternal/fetal. But the mechanisms and molecular mechanisms to improve the nutritional environment of the early embryo development are not clear. OBJECTIVE: To observe the effect of insulin-like growth factor 1 antagonist high glucose on mRNA expression and DNA methylation levels of the development-related imprinted genes H19/Igf-2 in mouse preimplantation embryos in vitro on the basis of preliminary work and starting from epigenetic prospect. METHODS: The diabetic mice models were established. The acquired early period 2-cell embryos were divided into experimental group and control group: the control group was high sugar adversity cultured in KSOM culture medium containing 30 mmol/L glucose, and the experimental group was treated with 100 μg/L insulin-like growth factor 1. Until growth to the blastocyst stage, the mRNA expression level of H19/Igf-2, and the DNA methylation level in imprinting control region of H19/Igf-2 were detected. RESULTS AND CONCLUSION: Real-time PCR analysis showed that the mRNA expression levels of H19 and Igf-2 in morulas were respectively 5.9 and 5.2 times as that of the control group (P < 0.01). Moreover, thus mRNA expression levels of H19 and Igf-2 in blastulas were separately 2.4 and 1.8 folds as that of the control group (P < 0.01). Bisulfite Sequencing PCR analysis demonstrated that the DNA methylation levels of H19 and Igf-2 in mouse morulas and blastulas of the experimental group were respectively declined by 27.9% and 20.9% than that of the control group (P < 0.01). The insulin-like growth factor 1 antagonist high glucose can partially reduce the DNA methylation level of H19/Igf-2 in imprinting control region in order to increase the mRNA expression levels of H19 and Igf-2, and it can antagonize the damage of high glucose during early mouse embryo development. Related Articles | Metrics

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Serum level of stem cell factor in a rat model of chronic renal failure Cui Yan, Liang Yao-xian, Liu Hong-yan, Liu Xue-mei, Xu Yan 2012, 16 (53):  10010-10014.  doi: 10.3969/j.issn.2095-4344.2012.53.025 Abstract ( 388 )   PDF (474KB) ( 630 )   Save BACKGROUND: Stem cell factor is a multifunctional cytokine, which may play an important role in the pathogenesis and progression of renal interstitial fibrosis. OBJECTIVE: To detect serum stem cell factor levels in rat models with chronic renal failure, and to study the relationship between serum stem cell factor and the pathogenesis and progression of renal interstitial fibrosis. METHODS: Thirty-six healthy male Wistar rats were randomly divided into model group (adenine lavage in order to establish the rat model with chronic renal failure) and control group (physiological saline lavage at equal volume). Six rats from both groups were sacrificed respectively at weeks 4, 8 and 12. Some serum and urine indicators were detected. Serum stem cell factor levels were measured by enzyme linked immunosorbent assay. The extent of renal interstitial fibrosis was observed by hematoxylin-eosin staining and Masson staining, and the renal interstitial fibrosis indices were calculated. Correlation between the serum stem cell factor and renal interstitial fibrosis indices was analyzed. RESULTS AND CONCLUSION: Compared with control group, the blood urea nitrogen, serum creatinine, serum stem cell factor and renal interstitial fibrosis indices were significantly higher in model group at different time points (P < 0.01). Moreover, the above indicators were gradually increased with the extension of lavage days, the serum stem cell factor level was positively correlated with blood urea nitrogen, serum creatinine and the degree of renal interstitial fibrosis (P < 0.01). The results suggest that stem cell factor may participate in the pathogenesis and progression of renal interstitial fibrosis. Related Articles | Metrics

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Protective effect of curcumin preconditioning and ischemic postconditioning against renal ischemia-reperfusion injury in rats Tao Jia-yi, Mi Hua, Mo Zeng-nan, Huang Wei-hua, Chen Kai, Liang Yi-yao, Huang Hai-peng,Li Sheng-hua 2012, 16 (53):  10015-10020.  doi: 10.3969/j.issn.2095-4344.2012.53.026 Abstract ( 342 )   PDF (614KB) ( 549 )   Save BACKGROUND: The studies have found that curcumin preconditioning and ischemic postconditioning have protective effect on renal ischemia-reperfusion injury. OBJECTIVE: To establish a model of renal ischemia-reperfusion injury and observe the protective effect of curcumin preconditioning, ischemic postconditioning and curcumin preconditioning combined with ischemic postconditioning on the renal ischemia-reperfusion injury of rats. METHODS: Sixty Sprague Dawley rats were randomly divided into five groups, namely sham-operation group, renal ischemia-reperfusion model group, curcumin preconditioning group, ischemic postconditioning group and curcumin preconditioning combined with ischemic postconditioning group (combination group). After reperfusion for 24 hours, the inferior vena venous blood was extracted to determine the values of blood creatinine and urea nitrogen. The superoxide dismutase activity and malondialdehyde value were measured in renal tissue, and hematoxylin-eosin staining was used to observe the changes in renal structure. RESULTS AND CONCLUSION: Compared with sham-operation group, the values of blood creatinine and urea nitrogen in other four groups were significantly increased (P < 0.05). Compared with ischemia-reperfusion model group, the values of blood creatinine and urea nitrogen in the urcumin preconditioning group, ischemic postconditioning group and combination group were significantly decreased after reperfusion for 24 hours (P < 0.05). Compared with urcumin preconditioning group and ischemic postconditioning group, the blood creatinine value of the combination group was significantly lower (P < 0.05). Compared with the sham-operation group, superoxide dismutase activity in the ischemia-reperfusion model group was decreased, while the value of malondialdehyde was increased significantly, the differences were statistically significant (P < 0.05). Compared with ischemia-reperfusion model group, urcumin preconditioning group, ischemic postconditioning group and combination group had higher superoxide dismutase activity, while the value of malondialdehyde was decreased; the differences were statistically significant (P < 0.05). Compared with urcumin preconditioning group and ischemic postconditioning group, superoxide dismutase activity of the combination group was significantly increased, and the difference was significant (P < 0.05). Compared with the sham-operation group, the renal tubular injury of ischemia-reperfusion injury model group was obvious; compared with ischemia-reperfusion model group, the urcumin preconditioning group, ischemic postconditioning group and the combination group had the significantly reduced tubular injury, and compared with urcumin preconditioning group and ischemic postconditioning group, the combination group had more significantly reduced tubular injury. Our study suggests that curcumin preconditioning combined with ischemic postconditioning has a synergistic effect; it can better protect the kidney from ischemia-reperfusion injur Related Articles | Metrics

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Mechanism of kidney injury in brain death rabbits Wang Jia-jia, Li Ling, Zhong Zi-biao, Fan Xiao-li, Qiao Bing-bing, Ye Qi-fa 2012, 16 (53):  10021-10026.  doi: 10.3969/j.issn.2095-4344.2012.53.027 Abstract ( 278 )   PDF (591KB) ( 530 )   Save BACKGROUND: Recent studies have reported that brain-dead donor organ injury and decreased graft quality after transplantation was related with non-specific inflammatory response. OBJECTIVE: To establish the rabbit brain death model, and to observe the change of kidney function and morphology in the rabbits at different time points after brain death and explore its possible mechanism, which provide experimental evidence for the clinical use of kidney transplant with brain-dead donor. METHODS: Slow intracranial pressure method was used to establish rabbit brain death model. Thirty healthy rabbits were divided into three groups. Normal group (n=5): maintained with continuous anesthesia and without any processed. Control group (n=5): abdominal surgery and drill craniotomy were performed after anesthesia. Experimental group (n=5): brain death model was established after anesthesia. The change of each indicator of the kidney was observed at 2, 4, 6 and 8 hours after brain death. RESULTS AND CONCLUSION: With the extension of time of brain death, the level of serum blood urea nitrogen, creatinine and interleukin-1β, interleukin-6, interleukin-8 and tumor necrosis factor α was increased gradually. Results of hematoxylin-eosin staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay showed that with the extension of brain death time, the extent of kidney injury was increased, as well as the expression of PKCα mRNA and the protein in kidney tissues. These results show that brain death state can lead to the change of kidney morphology and function in a time-dependent manner, and this phenomenon may be related with the activation of PKCα and release of inflammatory mediators. Related Articles | Metrics

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Expression and effect of heat shock protein 70 following rabbit brain death induced lung injury Li Ling, Wang Jia-jia, Fan Xiao-li, Zhong Zi-biao, He Chong-xiang, Ye Qi-fa 2012, 16 (53):  10027-10031.  doi: 10.3969/j.issn.2095-4344.2012.53.028 Abstract ( 320 )   PDF (760KB) ( 598 )   Save BACKGROUND: Donation after brain death has been the main source for organ transplantation. It is important to develop an effective method to protect the organ and improve its quality. OBJECTIVE: To investigate the effect of heat shock protein 70 on rabbit brain death induced lung injury. METHODS: The 60 rabbits were randomly divided into three groups: rabbits in the normal control group without surgery; the rabbits in the sham-operation group received femoral artery catheterization, endotracheal intubation and burr hole catheter, did not received the intracranial pressure; and the rabbits in the brain death group were treated with femoral artery catheterization, endotracheal intubation, burr hole catheter and intracranial pressure, and the ventilator was used to maintain a brain-dead state. Each group was further divided into four time points at 2, 4, 6 and 8 hours. The blood pressure and the heart rate were measured at each point. The changes of lung morphology were observed by hematoxylin-eosin staining. The mRNA and the protein expression of heat shock protein 70 were measured by reverse transcription-PCR and immunohistochemistry. RESULTS AND CONCLUSION: There was no significant difference in the blood pressure and the heart rate between the brain death group and sham-operation group (P > 0.05). The lung injuries in the sham-operation group at different time points were not obvious. From 2 to 6 hours, the lung injuries in the brain-death groups were getting worse in a time-dependent manner (P < 0.05), but somewhat amelioration at 8 hours group was observed when compared with the previous time group. The mRNA and the protein expression of heat shock protein 70 were gradually increased at 2 hours in a time-dependent manner (P < 0.05) and reached peak at 8 hours. These findings confirm that heat shock protein 70 can ameliorate brain death induced lung injury and play their defensive protection effect. Related Articles | Metrics

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Application of self-made handcuffs liver pincers in liver resection He Fang-yong, Li Shu-guang, Zhang Guo-zhi, Lu Wei-sheng, Chen Jian-li, Wang Chang-you, Zhao Peng,Wang Da-pe 2012, 16 (53):  10032-10036.  doi: 10.3969/j.issn.2095-4344.2012.53.029 Abstract ( 451 )   PDF (451KB) ( 532 )   Save BACKGROUND: Half liver, hepatic segments and partial liver resection can reduce the incidence of liver dysfunction and biliary fistula by half liver blood broken method and local blood flow blocking method with self-made handcuffs liver pincers. OBJECTIVE: To explore operation safety and influence of half liver, hepatic segments, partial liver resection on blood-flowing-change, function of liver and kidney by half liver blood broken method and local blood flow blocking method with self-made handcuffs liver pincers. METHODS: Eighty-five patients with half liver, hepatic segments, partial liver resection were selected, 31 patients that treated by liver blood broken method and local blood flow blocking method with self-made handcuffs liver pincers were considered as the experimental group; 54 patients in the same period were treated by liver amputation with out broken liver-door-blood way. The bleeding, biliary fistula, blood rheology and function of liver and kidney were compared after operation. RESULTS AND CONCLUSION: The 31 patients in the experimental had less bleeding, no biliary fistula and little influence in blood rheology and function of liver and kidney. It demonstrates that the half liver blood broken method and local blood flow blocking method with self-made handcuffs liver pincers for half liver, hepatic segments, partial liver resection are safe and effective. Related Articles | Metrics

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Effect of multi-drug resistance gene-1 C3435T genetic polymorphism on the concentration of cyclosporine A pharmacokinetics: A Meta-analysis Li Hai-ju, Ping Wei-wei, Song Li-hua, Guo Chun-hua, Zheng Wang-qiao 2012, 16 (53):  10037-10042.  doi: 10.3969/j.issn.2095-4344.2012.53.030 Abstract ( 368 )   PDF (458KB) ( 563 )   Save BACKGROUND: Multi-drug resistance gene-1 C3435T genetic polymorphism can influence the function and expression of P-glycoprotein, thus affecting the blood concentration of cyclosporine A, and lead to individual differences. The current studies of the influence of multi-drug resistance gene-1 C3435T genetic polymorphism on the concentration of cyclosporin A pharmacokinetics are inconsistent. OBJECTIVE: To evaluate the effect of multi-drug resistance gene-1 C3435T genetic polymorphism on the concentration of cyclosporine A pharmacokinetics according to the domestic studies. METHODS: Case-control studies and cohort studies were collected by searching Cochrane library, Medline database, PubMed database, CNKI database and Wanfang database and supplemented by literature retrospective method from building to 2011-12-31. All the relevant studies were identified and the quality of the included studies was assessed. The RevMan 5.1 software was used for Meta-analysis. RESULTS AND CONCLUSION: Nine studies with 893 patients were included. The results of Meta-analysis showed that the dose-adjusted c0 level of cyclosporine A of multi-drug resistance gene-1 3435CC genotype was lower than of the CT genotype (P=0.007) and TT genotype (P=0.000 6). The subgroup analysis found that the dose-adjusted c0 level of multi-drug resistance gene-1 3435CC genotype was lower than that of CT genotype (P < 0.000 01) and TT genotype (P=0.000 3) in the patients after renal transplantation. The dose-adjusted c0 level of multi-drug resistance gene-1 3435CC genotype was lower than that of TT genotype (P=0.004) in the patients with hematological diseases. The dose-adjusted c2 level of the multi-drug resistance gene-1 3435CC genotype was lower than that of the TT genotype (P=0.005). The multi-drug resistance gene-1 C3435T genetic polymorphism can influence the blood concentration of cyclosporine A, and the blood concentration of multi-drug resistance gene-1 3435CC genotype was lower than that of TT genotype. High quality and large scale prospective trials are required to study the influence of multi-drug resistance gene-1 C3435T genetic polymorphism on cyclosporine A pharmacokinetics. Related Articles | Metrics

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Meta analysis on the efficacy of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion Xing Dan, Ma Xin-long, Song Dong-hui, Ma Jian-xiong, Wang Jie, Chen Yang, Yang Yang 2012, 16 (53):  10043-10047.  doi: 10.3969/j.issn.2095-4344.2012.53.031 Abstract ( 346 )   PDF (395KB) ( 435 )   Save BACKGROUND: How to improve lumbar fusion rates and reduce complications after lumbar spinal fusion is an important topic of orthopedics. OBJECTIVE: To collect and analyze the literatures and to evaluate the effectiveness and security of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion. METHODS: A computer-based search was performed on PubMed database and Embase database combined with manual search for the articles relate to the effect of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion according to the inclusion and exclusion criteria. The radiographically nonunion rate, operating time, blood loss and hospitalization days of these two materials were compared. Parts of the data were processed by Meta-analysis, and the odds ratio and 95% confidence interval of the outcome indicators were estimated. RESULTS AND CONCLUSION: A total of 4 related papers including four randomized control trials were included. There were 109 patients, among them 61 patients were fused with osteogenic protein-1 and 48 patients were fused with autologous bone graft. There was no significant difference of radiographically demonstrated nonunion rate [odds ratio=1.16, 95% confidence interval (0.44, 3.07)], operation time, blood loss, hospitalization days, reoperation rate, Oswestry disability index between osteogenic protein-1 and autologous bone graft (P > 0.05). There was no intervention related adverse event appeared. Osteogenic protein-1 may be an effective and safe alternative to autologous bone graft in posterolateral lumbar fusion. The most important advantage was that the osteogenic protein-1 could avert the morbidity of harvesting bone from the iliac crest and also could meet the need of adequate quantity of bone graft. Current literature needs large, well designed and conducted randomized control trials in clinical appplication. Related Articles | Metrics

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Expression and effect of renal injury markers and the changes under different conditions Song Lei, Ye Ming-ji, Xie Xu-biao, Peng Long-kai 2012, 16 (53):  10048-10054.  doi: 10.3969/j.issn.2095-4344.2012.53.032 Abstract ( 385 )   PDF (698KB) ( 681 )   Save BACKGROUND: With the development of new renal injury markers as well as the expression and mechanism in different renal diseases, an important progress has achieved in the protection of renal disease. OBJECTIVE: To summarize the research progress of renal injury markers. METHODS: The PubMed database was searched using the computer for articles published from January 2006 to October 2011 using the key words of “renal injury, markers” in English. Simultaneously, China Journal Full-text database were retrieved for articles published from January 2006 to October 2011 using the key words of “renal injury, markers” in Chinese. Besides, Conference Proceedings of English and Chinese were retrieved by hand. Finally, 50 articles were included according to the inclusion criteria. RESULTS AND CONCLUSION: The prediction and expression of the renal injury markers in different renal disease is distinct. According to time, the renal injury markers can be divided into acute and chronic kidney damage; according to the structure and function, the markers can be divided into glomerular, tubular and glomerular filtration rate; according to the source of specimen, the markers can be divided into blood, urine and tissue biopsy. These markers can not only early detect kidney disease, assess acute kidney injury and can determine the outcome of chronic renal injury. The diversification of renal injury markers is earlier than that of serum creatinine, and the renal injury markers have high sensitivity and specificity, but the screening and clinical application of renal injury markers needs further study on the changes in different individuals, different phase and different comorbidities or complications of kidney damage, and establish the early warning platform in order to achieve the purpose of early diagnosis and treatment of renal injury. Related Articles | Metrics

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Flap transplantation combined with closed negative pressure drainage for repairing lower extremity skin and soft tissue defects Xu Min-chao, Zheng Qiong, Chen Ming, Pan Hao, Kan Wu-sheng 2012, 16 (53):  10055-10062.  doi: 10.3969/j.issn.2095-4344.2012.53.033 Abstract ( 308 )   PDF (872KB) ( 702 )   Save BACKGROUND: Various traumas caused lower extremity skin and soft tissue defects are very common and often accompanied by severe blood supply damage and wound infection with high infection rate and not easy to heal. OBJECTIVE: To systematic review the literatures on the treatment of lower extremity skin and soft tissue infections defect, and to explore the indications, methods and clinical significance of flap transplantation combined with closed negative pressure drainage for repairing lower extremity skin and soft tissue defects combined with the treatment results of 23 patients with lower extremity skin and soft tissue defects treated in Pu Ai Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology. METHODS: Twenty-three patients with lower extremity skin and soft tissue defects treated in Pu Ai Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology were selected from August 2004 to November 2011, 15 cases in male and 8 cases in female; the age was 17-56 years, average 31.4 years. All the patients were treated with flap transplantation combined with closed negative pressure drainage. The follow-up time was 4-15 months, average 7.3 months, and then the clinical effects were observed. The relative literatures on the lower extremity skin and soft tissue defects were screened and found the similar treatment objects and the same evaluation criteria for comparison. RESULTS AND CONCLUSION: Among the 23 patients with lower extremity skin and soft tissue defects, the wound infections bacteria including Gram-positive bacteria accounted for 52.2%, Gram-negative bacteria accounted for 47.8% and multi-resistant bacteria accounted for 43.5%. After treated with closed negative pressure drainage, the wound infection was effectively controlled and the growth of wound granulation tissue was good. The wound was healed after flap transplantation. The results showed that flap transplantation combined with closed negative pressure drainage for repairing lower extremity skin and soft tissue defects could shorten wound healing time. Related Articles | Metrics

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Rehabilitation exercise therapy after renal transplantation Mo Wei-bin, Gong Ming-ming, Xu Jun 2012, 16 (53):  10063-10066.  doi: 10.3969/j.issn.2095-4344.2012.53.034 Abstract ( 391 )   PDF (577KB) ( 470 )   Save BACKGROUND: Kidney transplantation is the most effective method for the treatment of end-stage kidney disease, and the rehabilitation exercise therapy at late stage of renal transplantation has great significance to improve the mental state and life quality of the patients. OBJECTIVE: To analyze the method and significance of the rehabilitation exercise therapy at late stage of renal transplantation, in order to promote the mental and psychological recovery of renal transplant patients, thereby improving the quality of life of patients. METHODS: The patients received the rehabilitation exercise therapy after renal transplantation, and a reasonable treatment option was formulated to analyze the treatment effect of rehabilitation exercise therapy on the physical health and mental health and to clarify the effect of rehabilitation exercise therapy on the function of body. RESULTS AND CONCLUSION: Rehabilitation exercise therapy after renal transplantation can reduce the anxiety, depression and other psychiatric symptoms, promote the recovery of the patient's physical and psychological health and beneficial for the patients to adapt to the social function. Meanwhile, rehabilitation exercise therapy can help to adjust the changes of body weight, blood pressure, blood lipids and blood glucose, prevent the occurrence of cardiovascular and cerebrovascular diseases and improve the life quality of the patients. Related Articles | Metrics

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Investigation of medical students’ attitude and cognition to human organ transplantation and donation Zhang Xue-wen, Li Guan-yan, Li Zhen, Chu Hong-qian 2012, 16 (53):  10067-10070.  doi: 10.3969/j.issn.2095-4344.2012.53.035 Abstract ( 649 )   PDF (413KB) ( 767 )   Save BACKGROUND: Medical students’ cognition and attitude on the organ transplantation can affect the awareness of the whole society about organ transplantation and donation, thereby affecting the process of organ donation and transplantation. OBJECTIVE: To survey the attitudes and cognitions of the school medical students about human body organ transplantation and donation. METHODS: 400 students from Jining Medical School were selected for the questionnaire survey. Main content includes: (1)The master of organ transplantation and organ (body) donation knowledge. (2)The source of organ transplantation and organ donation (body) knowledge. (3)The attitude of organ (body) donation. RESULTS AND CONCLUSION: About 69.8% of school medical students know the concept of organ transplantation and donation, 44.6% agree for donating their organs after death. It proves that the school medical students approve that organ transplantation is an effective means to treat the end-stage organ function failure, but they are not optimistic about organ donation. The main factors of affecting the attitude of donation are family emotion, donation program and traditional ideas. Grade 1 has the lowest approving rate of 26.6%, and Grade 5 has the highest of 61.4%, higher grade has higher approving rate. About 55.6% of medical students hold that organ donors should be given a certain amount of reward or compensation. Related Articles | Metrics