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31 December 2011, Volume 15 Issue 53 Previous Issue    Next Issue

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Effects of tacrolimus and sirolimus on generation of Foxp3+ regulatory T cells and recurrence of hepatocellular carcinoma in patients with hepatocellular carcinoma after liver transplantation Chen Guo-yong, Sun Jian-jun, Li Cai-li, Chen Jian-bin, Tang Gao-feng, Xie Zhan-tao, Zhao Hui-bo, Ji Jie, Jiang Jin-fa 2011, 15 (53):  9881-9884.  doi: 10.3969/j.issn.1673-8225.2011.53.001 Abstract ( 313 )   PDF (1135KB) ( 616 )   Save BACKGROUND: Increasing the generation and function of regulatory T cells has become an effective means of maintaining the immune tolerance of grafts. OBJECTIVE: To study the effects of tacrolimus and sirolimus on generation of Foxp3+ regulatory T cells and recurrence in patients with hepatocellular carcinoma after liver transplantation. METHODS: Forty patients with hepatocellular carcinoma accord to Milan criteria were randomly divided into tacrolimus group and sirolimus group with 20 patients in each group. Peripheral blood of patients was extracted monthly during the 2-12 months after transplantation for detection of Foxp3+ regulatory T cells. Color doppler ultrasound and the peripheral blood alpha-fetoprotein detection were performed. Liver biopsy was performed to observe the rejection and recurrence.  RESULTS AND CONCLUSION: Flow cytometry results showed that positive rate of Foxp3+ regulatory T cells in the sirolimus group was significantly increased compared with the tacrolimus group (P < 0.05). Liver biopsy showed no significant difference in rejection between the two groups (P > 0.05). The hepatocellular carcinoma recurrence rate in the sirolimus group was obviously lower than the tacrolimus group by color doppler ultrasound, peripheral blood alpha-fetoprotein detection and liver biopsy (operation) (P < 0.05). It is suggested that sirolimus is superior to tacrolimus in inhibiting recurrence of liver transplantation, and the rejection of sirolimus does not increase compared with tacrolimus, or even has better results in immunological tolerance. Related Articles | Metrics

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Proliferation and differentiation of recipient-sourced hepatic oval cells in liver graft after cell seeding Li Zhu, Chen Juan, Li Xue-hua1, Liu Zhi-heng, Liu Gui-jie, Zhang Xue-li, Gao Yan-chao, Sun Hui-dong,Ji Pi-you, Li Li, Zhang Jin-liang 2011, 15 (53):  9885-9888.  doi: 10.3969/j.issn.1673-8225.2011.53.002 Abstract ( 383 )   PDF (1138KB) ( 367 )   Save BACKGROUND: Hepatic oval cells (HOCs) exhibit repair effects on liver injury after cell seeding. OBJECTIVE: To observe the effects of recipient-sourced HOCs on survival time and liver function of recipient rats after liver transplantation and HOC seeding. METHODS: Rats orthotopic liver transplantation models were established by Kamada two-cuff technique. Female DA rats served as donors, and female Lewis rats were used as recipients. Recipients were randomly divided into a control group (no cell seeding) and an experimental group (recipient-sourced HOCs seeding through portal vein and hepatic artery during liver transplantation, 1×109/L). RESULTS AND CONCLUSION: The median survival time and accumulated survival rate in the experimental group were better than those in the control group (P < 0.05). Degree of hepatocyte injury in the experimental group was mild than that in the control group (P < 0.05), and liver synthetic function and liver excretion function in the experimental group were much better than those in the control group (P < 0.05). These findings suggest that seeding of recipient-sourced HOCs into liver graft can effectively improve liver function, obviously prolong median survival time and increase accumulated survival rate in recipients after liver transplantation. These results might be related to the proliferation and differentiation of recipient-sourced HOCs in liver graft, the repair of liver injury and alleviated acute rejection. Related Articles | Metrics

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Salvage liver transplantation as a rescue operation for recurrent hepatocellular carcinoma after partial hepatectomy Xia Yu-jian, Pan Fan, Lü Li-zhi, Cai Qiu-cheng, Yang Fang, Jiang Yi 2011, 15 (53):  9889-9892.  doi: 10.3969/j.issn.1673-8225.2011.53.003 Abstract ( 291 )   PDF (694KB) ( 485 )   Save BACKGROUND: As donor organs shortage are serious at present, salvage liver transplantation strategy offers a new way to solve the problem. OBJECTIVE: To contrast the efficacies of salvage liver transplantation for postoperative tumor recurrence and primary liver transplantation in hepatocellular carcinoma patients who meet Milan criteria. METHODS: A total of 53 hepatocellular carcinoma patients with tumor met Milan criteria who underwent liver transplantation in the Department of Hepatobiliary Surgery of Fuzhou General Hospital from July 2001 to August 2009 were included. Among them, 12 cases met the Milan criteria of postoperative tumor recurrence and received salvage liver transplantation. While 41 patients received primary liver transplantations. RESULTS AND CONCLUSION: The operation time, anhepatic phase, the volume of blood loss, suspension red blood cell transfusion during operation, ICU time, total hospitalization time, the total cost of hospitalization in salvage liver transplantation group were significantly larger than that in the primary liver transplantation group (P > 0.05). There was no significant difference in fresh frozen plasma transfusion between the two groups (P < 0.05). There was no significant difference in the overall survival rates between the two groups throughout the follow-up period of 39 months (P > 0.05). It demonstrates that liver resection prior to liver transplantation can be integrated with the treatment strategy for hepatocellular carcinoma patients with tumor meets Milan criteria. Related Articles | Metrics

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Upper gastrointestinal bleeding after adults orthotopic liver transplantation Zhu Zhi-dong, Du Guo-sheng, Shi Bing-yi, Song Ji-yong, Zheng De-hua, Cui Hong-tao 2011, 15 (53):  9893-9896.  doi: 10.3969/j.issn.1673-8225.2011.53.004 Abstract ( 320 )   PDF (410KB) ( 549 )   Save BACKGROUND: Upper gastrointestinal bleeding (UGIB) is one of the more common complications in liver transplantation, the incidence of reported abroad was up to 8.9% and of reported domestic was 5%. OBJECTIVE: To investigate the causes and treatment methods of UGIB after adult orthotopic liver transplantation. METHODS: Totally 412 patients with UGIB after orthotopic liver transplantation was retrospectively reviewed. The bleeding causes and effect of hemostatic process on patient and grafts survival were analyzed. RESULTS AND CONCLUSION: Totally 16 cases were subjected to UGIB during the first postoperative two months, including 8 cases with gastroduodenal ulcers bleeding, 4 cases with gastric fundus and esophagus variceal bleeding, 4 cases with hemobilia and 4 cases were dead. Bleeding inducements included that application of high-dose corticosteroids in acute rejection, serious infections, biliary fistula, hepatic artery pseudoaneurysm formation, percutaneous transhepatic biliary drainage, liver biopsy and so on. Eight cases underwent successful hemostasis by medical treatment, three cases underwent successful intervention treatment and one case underwent successful hemostasis by laparotomy. Peptic ulcers is the most common causes of UGIB following orthotopic liver transplantation, variceal bleeding and hemobilia are the second. After definite diagnosis, reasonable treatment should be immediately received, and active preventive measures should be also given to the patients according to the situation before transplantation. Related Articles | Metrics

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Liver transplantation for Wilson’s disease Lü Shao-cheng, Shi Xian-jie, Liang Yu-rong, He Lei, Ji Wen-bin, Lu Fang, Chen Yong-wei, Luo Ying 2011, 15 (53):  9897-9900.  doi: 10.3969/j.issn.1673-8225.2011.53.005 Abstract ( 301 )   PDF (522KB) ( 454 )   Save BACKGROUND: Liver transplantation can provide healthy liver tissue for Wilson’s disease patients to correct their genetic defects, and it can relive clinical and neuropsychiatric symptoms induced by copper metabolism and cirrhosis. OBJECTIVE: To investigate the effects of liver transplantation on Wilson’s disease. METHODS: Seventeen cases were selected. Three cases were treated with cadaveric liver transplantation, and 14 cases were treated with living-related liver transplantation. In all the cases, artery reconstruction was conducted through end-to-end anastomosis between donor hepatic artery and recipient hepatic artery. The duct-to-duct biliary reconstruction was performed, and no support pipe was placed in the biliary duct for drainage during operation. RESULTS AND CONCLUSION: One patient died of hemorrhage perioperatively. Fifteen patients survived more than 1 year and 10 patients survived more than 3 years. Of the eight patients with nervous system dysfunction, six patients had improved neuropsychic symptoms to various degrees after operation. The liver function and serum ceruloplasmin level were improved significantly in the 15 patients undergoing liver transplantation surviving more than 1 year (P < 0.05). It suggests that liver transplantation can correct patients’ metabolic defects, which is an effective therapy for Wilson’s disease. Related Articles | Metrics

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Effect of Myfortic and CellCept combined with proton pump inhibitor on mycophenolic acid in kidney transplantation patients Xu Liang, Cai Ming, Jin Hai-long, Wang Qiang, Xu Xiao-guang, Shi Bing-yi 2011, 15 (53):  9901-9904.  doi: 10.3969/j.issn.1673-8225.2011.53.006 Abstract ( 375 )   PDF (653KB) ( 539 )   Save BACKGROUND: The absorption and metabolism places in vivo of Myfortic are different with classic immunosuppressant CellCept, this is due to the combination with related drugs and results in the different clinical effects.  OBJECTIVE: To explore the effect of Myfortic and CellCept combined with proton pump inhibitor (PPI) on mycophenolic acid in kidney transplantation patients. METHODS: Seventeen patients with Myfortic and 16 patients with CellCept who were treated in the 309 Hospital of Chinese PLA as study group during May 2010 to May 2011. Myfortic/CellCept+ciclosporin/Tacrolimus+steroid hormone was regarded as the immunosuppressive regimen, 540 mg Myfortic and 750 mg CellCept was injected once every 12 hours. RESULTS AND CONCLUSION: The kidney function of the patients was recovered to normal in Myfortic and CellCept groups. The average peak time, peak concentration, half life period and the area under the curve of the mycophenolic acid in Myfortic group were higher than those in the CellCept group (P < 0.05). It indicates that the therapeutic efficacy of Myfortic combined with PPI on mycophenolic acid in kidney transplantation patients is better than that of CellCept. Related Articles | Metrics

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Changes of urine CD54+ lymphocytes in acute rejection after renal transplantation Li Sha-dan, Wang Liang, Wang Qing-tang, Chen Wei-guo, Yang Hang, Zhou Peng, Liang Ping, Li Xiao-wei 2011, 15 (53):  9905-9908.  doi: 10.3969/j.issn.1673-8225.2011.53.007 Abstract ( 266 )   PDF (588KB) ( 420 )   Save BACKGROUND: The expression of CD54 is low in normal kidney, renal tubular epithelium and vascular endothelial cells. CD54 expression in renal tubular epithelial cells and vascular endothelial cells increases obviously when acute rejection occurres. In the meantime, the CD54 expression level in renal tubular epithelial cells increases along with interstitial renal edema and massive leukocyte infiltration. OBJECTIVE: To assess the value of flow cytometer detection for urine CD54+ lymphocytes in the diagnosis of acute rejection after renal transplantation. METHODS: Participants were renal transplant recipients from General Hospital of Chengdu Military Area Command of Chinese PLA, including patients obtained normal renal function (n=18), patients with acute rejection (n=8) and patients with graft dysfunction (n=9). Healthy volunteers were included as control (n=10). Urine CD54+ lymphocyte rates of each group were compared by flow cytometer before and after transplantation. RESULTS AND CONCLUSION: The expression of urine CD54+ lymphocytes in renal transplant recipients increased significantly during the rejective time (P < 0.01), and reduced gradually after anti-rejction treatment. The expression of CD54 increased moderately in patients obtained normal renal function and patients with graft dysfunction. These findings indicate that CD54+ lymphocyte level in urine can accurately reflect the immune condition of renal transplant recipients and could be used as a specific parameter in the diagnosis of acute rejection after renal transplantation. Related Articles | Metrics

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Mental health evaluation of patients with maintained hemodialysis before and after kidney transplantation Bi Su-feng, Bi Hui, Zhang Min, Long Gang 2011, 15 (53):  9909-9912.  doi: 10.3969/j.issn.1673-8225.2011.53.008 Abstract ( 411 )   PDF (628KB) ( 541 )   Save BACKGROUND: Renal allograft failure is one of the most familiar reasons of end-stage renal disease. The survival time in maintained hemodialysis patients improves remarkably. OBJECTIVE: To measure and evaluate the mental health condition of patients with maintenance hemodialysis before and after kidney transplantation． METHODS：A total of 106 hemodialysis patients and 100 chronic renal insufficiency patients who did not take any dialysis (as control) were involved. Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90) and Eysenck Personality Questionnaire (EPQ) were used as survey tools to evaluate the patients’ mental health condition. The scores of the two groups were compared with each other and with that of the norm. RESULTS AND CONCLUSION: The mean SCL-90 scores of the two groups were significantly higher than that of the norm, and hemodialysis patients had higher scores than control people in the aspects of interpersonal sensitivity, depression, anxiety, sleep and diet (P < 0.05). Chronic renal insufficiency patients who did not take any dialysis had higher factor scores in somatization than hemodialysis patients (P < 0.01). The mean scores of SAS and SDS in the two groups were significantly higher than that in the norm, and the scores in the hemodialysis group were significantly higher than that in the control group (P < 0.01). The scores of E and N in the personality scale of hemodialysis group were higher than that of the control group (P < 0.01). These findings indicate that end-stage renal disease patients still have severe physical and mental problems after regular hemodialysis treatment. Especially, the condition in the aspects of interpersonal sensitivity, depression, anxiety and sleep worsens after hemodialysis. Hemodialysis patients are emotionally unstable. So the treatment on the mental condition in maintained hemodialysis patients should be strengthened on the basis of sufficient hemodialysis. Related Articles | Metrics

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Psychological, behavioral, and willingness investigations of living donors for kidney transplantation in Northwest China Chen Guo-zhen, Pan Xiao-ming, Ding Chen-guang 2011, 15 (53):  9913-9916.  doi: 10.3969/j.issn.1673-8225.2011.53.009 Abstract ( 438 )   PDF (597KB) ( 538 )   Save BACKGROUND: Doctors should understand the psychology, behavior and will of the donors in order to avoid their psychological concerns before kidney transplantation and maintain a high quality of life after surgery. OBJECTIVE: To investigate the psychology, behavior, and will of living donors for kidney transplantation in Northwest China. METHODS: Totally 200 donors received living donor kidney graft or not in the First Affiliated Hospital of Medical College of Xi’an Jiaotong University were involved. This retrospective study was performed by an interview or telephone using a questionnaire. The 13-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor feedback. Donors were asked to rate the queries on a 5-point Likert intensity scale. RESULTS AND CONCLUSION: In the results, 78.5% of the cases felt honor to be a donor, and 70.5% believed that donor was a hero. 79% of the donors thought that their relationship between the recipients could be improved after surgery, 73.5% of them hoped to find brain-dead organ donor, and 61.5% of them hoped relative donors. The results not only present the basic view of people in Northwest China to be a kidney donor, but also reflect the problems in living organ transplantation of China. Related Articles | Metrics

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Short-term outcomes of renal transplant recipients receiving kidney grafts from brain-death donors Wang Bang-qi, Zhu Yun-song, Nie Hai-bo, Zhao Yong-bin, Hu Wei-lie 2011, 15 (53):  9917-9920.  doi: 10.3969/j.issn.1673-8225.2011.53.010 Abstract ( 378 )   PDF (701KB) ( 446 )   Save BACKGROUND: The shortage of donors has severely limited the development of renal transplantation. However, brain-death donors can alleviate the problem of renal transplantation donor shortage to some extent. OBJECTIVE: To compare the short-term outcomes of renal transplantation recipients receiving kidney grafts from brain-death and cadaveric brainstem dead donors and evaluate the safety of kidney grafts from brain-death donors. METHODS: A total of 90 patients receiving renal transplantation were retrospectively analyzed, including 10 patients receiving kidney graft from brain-death donors and 80 with grafts from cadaveric brainstem dead donors. The operative time, bleeding volume, postoperative complications and short-term survival were compared between the two groups. RESULTS AND CONCLUSION: The operative time, bleeding volume, postoperative complications and short-term survival showed no significant differences between the two groups. The short-term outcome of recipients receiving kidney grafts from brain-death donors is similar to that of recipients receiving grafts from cadaveric brainstem dead donors, indicating the safety of clinical use of the kidney grafts from brain-death donors. Related Articles | Metrics

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Clinical effects of living donor kidney transplantation in 178 cases from Xinjiang area Mikereyi•Aizimaiti, Reyihan, Liu Jian 2011, 15 (53):  9921-9924.  doi: 10.3969/j.issn.1673-8225.2011.53.011 Abstract ( 367 )   PDF (791KB) ( 448 )   Save BACKGROUND: Xinjiang is a rare region where populations of minority and Han nationalities live together. There have been no confirmative reports describing race difference in living donor kidney transplantation between population of minority nationality and population of Han nationality. OBJECTIVE: To summarize and analyze Xinjiang living kidney transplantation and clinical experience to provide clinical guidance. METHODS: A retrospective analysis of clinical data of living kidney transplantation recipients who underwent kidney transplantation between 1999 and 2010 in Xinjiang. Preoperative general condition and postoperative complications of the living kidney recipients, and graft survival rate after transplantation in population of minority nationality versus population of Han nationality were analyzed. One-way analysis of variance was performed to analyze various factors that may influence graft survival rate. RESULTS AND CONCLUSION: A total of 178 patients provided complete follow up data, including 131 patients of minority nationality and 47 patients of Han nationality. The graft survival rate was slightly higher, but not significantly, in the recipients of Han nationality than in those of minority nationality. Cox analysis of factors that may influence survival rate of grafts showed that acute rejection greatly influences graft survivals. These findings suggest that the short- and medium-term graft survival rate is similar between populations of different nationalities in Xinjiang who receive living kidney transplantation and acute rejection is the important factor that influences graft survival rate. Related Articles | Metrics

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Endoscopic techniques on treatment of upper urinary tract calculi in transplanted kidneys He Zhao-hui, Zeng Guo-hua, Yuan Jian, Shan Zhi-chang, Li Xun 2011, 15 (53):  9925-9928.  doi: 10.3969/j.issn.1673-8225.2011.53.012 Abstract ( 266 )   PDF (605KB) ( 443 )   Save BACKGROUND: Urolithiasis is an uncommon but known complication of renal transplantation and its management is challenging because of the special physiopathology of transplanted kidneys. OBJECTIVE：To summarize our experience of endoscopic techniques on the treatment of upper urinary tract calculi in transplanted kidney and to evaluate its safety and effectiveness. METHODS: The clinical data of 21 patients with upper urinary tract calculi in transplanted kidneys treated by ureteroscopic lithotripsy (URL) or minimally invasive percutaneous nephrolithotomy (mPCNL) was retrospectively analyzed. RESULTS AND CONCLUSION: 8 patients with ureteral stones in transplanted kidney were treated by URL and the procedure was successful only in 3 cases, 2 cases had high fever after stone and 1 of them required a nephrostomy tube to control infection. The other 5 were failed and converted to mPNCL. Total of 18 patients were treated by mPCNL. Among them, 13 patients were treated with mPCNL directly, 5 patients were treated with URL at first and failed and then converted to mPNCL. All patients were rendered stone-free at one mPCNL procedure, with no complications during or after surgery. In treating the calculi in transplanted kidney, the value of URL is limited but mPCNL is safe and effective and it can be regard as the initial therapy. Related Articles | Metrics

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Diagnosis and treatments of pneumonia in 17 patients following kidney transplantation Lin Yu-hong, Che Xiang-qian, Zhang Li-li, Ma Zhuang 2011, 15 (53):  9929-9933.  doi: 10.3969/j.issn.1673-8225.2011.53.013 Abstract ( 326 )   PDF (633KB) ( 430 )   Save BACKGROUND: Pneumonia is the common complication and main cause of death after kidney transplantation.  OBJECTIVE: To investigate the clinical features, diagnosis and treatment methods of pneumonia in kidney transplant patients. METHODS: Clinical data of 17 cases of pneumonia who received renal transplantation from May 2008 to December 2010 were retrospectively analyzed. RESULTS AND CONCLUSION: Among 17 patients, 12 patients (70.6%) and 1 patient (5.9%) developed pneumonia within 6 months and 6-12 months respectively after renal transplantation, and 4(23.5%) patients developed pneumonia 12 months later. 14(82.4%) patients obtained pathogenic results, including gram negative bacillus (8 cases, 47.1%), cytomegalovirus (7 cases, 41.2%), gram positive coccus (6 cases, 35.3%), pneumocystis carinii (3 cases, 17.6%), tuberculosis (3 cases, 17.6%),  candidiasis albicans (3 cases, 17.6%), legionella (1 case, 5.9%). Single causative organism could be found in only 5 cases and multiple etiologies were found in 9 cases. No definitive cause could be found in 3 cases. 9 cases (52.9%) survived and 8 cases (47.1%) died. Most of pneumonia in renal transplant recipients can be attributed to multiple organisms. Bronchoscopy is important in the finding of microorganisms. Beside proper antibiotics, combined therapy and adjustment of immunosuppressants are of equal importance. Related Articles | Metrics

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Effects of oral administration of donor spleen cells on kidney transplantation in rats Yu Xue-song, Huang Chi-bing, Zou Sheng-an, Fan Ming-qi, Wang Ping-xian, Feng Jia-yu, Xiao Ya 2011, 15 (53):  9934-9937.  doi: 10.3969/j.issn.1673-8225.2011.53.014 Abstract ( 242 )   PDF (1130KB) ( 341 )   Save BACKGROUND: It is proved that oral administration of donor antigen can induce immunology tolerance effectively. The spleen is the biggest human lymphoid organ containing many T lymphocytes and can provide abound antigens. OBJECTIVE: To observe the effects of oral administration of donor spleen cells on rat kidney function after transplantation. METHODS: Before kidney transplantation, Lewis (RT11) rats in splenocytes group were fed with 5×105 donor splenocytes by gastric intubation daily for 7 days, while Lewis (RT11) rats in transplantation group were fed with 1 mL PBS as control. RESULTS AND CONCLUSION: On the 5th day after transplantation, allografts rejection symptoms began appearing in the transplantation group. Mean survival time of splenocytes group was longer than that of the transplantation group. After transplantation, the serum creatinine and urea nitrogen level in splenocytes group increased slower than that in the transplantation group. According to hematoxylin-eosin staining, the acute rejection occurred earlier in transplantation group than that in the splenocytes group. It demonstrates that oral administration of donor spleen cells can induce immune tolerance and prolong the survival time of kidney allografts. Related Articles | Metrics

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Axial myocutaneous flap transplantation for repair of refractory wound in the cervico-thoracic region Li Hong-mian, Gao Jian-hua, Jiang Ping, Li Xiao-jian 2011, 15 (53):  9938-9942.  doi: 10.3969/j.issn.1673-8225.2011.53.015 Abstract ( 361 )   PDF (1629KB) ( 446 )   Save BACKGROUND: Axial myocutaneous flap transplantation is the common method for repair of various refractory. This method had certain blindness in judgment of the main arteries in flaps before surgery in the past. Therefore, it is important to develop a more accurate method. OBJECTIVE: To introduce the application experiences of axial myocutaneous flap in repair of refractory wound in the cervico-thoracic region. METHODS: Color doppler flow imaging was used to examine the starting point, branching point, exterior diameter, vessel trend, vessel length and hemodynamic parameters of the main arteries of 4 types flaps from 62 cases. The axial myocutaneous flaps were designed according to the detection. The sizes of the axial myocutaneous flaps ranged from (9 cm×7 cm) to (18 cm×13 cm). RESULTS AND CONCLUSION: According to color doppler flow imaging, one case of thoracodorsal artery had slow blood flow, rough vascular wall and obvious arteriosclerosis, and the other cases were with smooth blood flow and vascular wall, and without embolism, arteriosclerosis or absence of blood vessel. The starting point, branching point, exterior diameter, vessel trend and anatomic layers of the detected arteries were displayed clearly, in consistency with the results of operation; the flap completely survived in 60 cases with primary healing; distal partial necrosis occurred in 2 cases and was cured by symptomatic treatment. All the cases were followed up for 4 weeks to 6 years, 24 months in average, and the flaps were with a normal color, good texture and satisfactory appearance. Choosing a suitable pedicled musculocutaneous flap for refractory wound in cervico-thoracic region according to specific conditions can achieve satisfactory function and appearance. Color doppler flow imaging is a simple, intuitive and and non-invasive method to judge blood vessels of axial myocutaneous flaps, and can guide the axial myocutaneous flap transplantation. Related Articles | Metrics

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Feasibility of staged allogeneic larynx transplantation in dogs Jiang Yan, Dong Pin, Li Na, Li Xiao-yan, Xu Hong-ming, Zhang Nian-kai 2011, 15 (53):  9943-9948.  doi: 10.3969/j.issn.1673-8225.2011.53.016 Abstract ( 366 )   PDF (423KB) ( 389 )   Save BACKGROUND: The key to success in laryngeal transplantation is to control the infection. In practice, how to minimize the risk of infection should be considered first, so that the laryngeal allograft can survive after revascularization under the immunosuppressive state. Then the therapeutics methods should be focused on the functional recovery of respiratory, swallowing and phonation. OBJECTIVE: To explore the feasibility of staged allogeneic larynx transplant for dogs in order to decrease the infection rate. METHODS: Ten male conspecific Beagle dogs were assigned into five pairs of donor and receptor according to body mass and the size of larynx. The allogeneic larynx was embedded under the neck skin by allotransplantation. The dogs were treated with immunosuppressant daily to resist immnological rejection. The pharynx and trachea were contraposed after larynx survived to establishⅡstage laryngeal transplantation animal model. RESULTS AND CONCLUSION: InⅠstage of laryngeal transplantation, the laryngeal allograft survived well, blood supply was passable. Receptor dog 1 with vertical midline incision in the neck, receptor dogs 4 and 5 with transverse incisions in the neck grew well. No infection phenomena was found in receptor dogs 4 and 5. The lastⅡstage laryngeal transplantation was performed in the 4th week afterⅠstage laryngeal transplantation. Skin flap necrosis occurred in receptor dogs 2 and 3 with U-shape incisions. The donor larynx had different degree infection. Laryngeal allograft of receptor dog 2 died; laryngeal allograft of receptor dog 3 survived after treatment. The survival period of donor larynx in receptors was as long as 4 weeks. These findings indicate that the larynx infection is avoid or reduced by staged larynx transplantation with pre-embed laryngeal allograft after total laryngectomy. The receptor dog is tolerant; the donor larynx is easy to survive. The main histological change occurs in the epithelial mucosae which can be used as an inspect index of immunosuppressive agents. However, glandular organ secretion is a troublesome problem and immunodepressant must be continuously administrated for a long time. Related Articles | Metrics

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Combination of astragalus and Xuebijing injections for pulmonary infection after renal transplantation Nie Feng, Sun Xu-yong, Li Zhuang-jiang, Tan Qing, Lai Yan-hua, Dong Jian-hui, Huang Ying, Wu Ji-hua, Cao Song, Ma Qian-hua, Li Mei-si 2011, 15 (53):  9949-9952.  doi: 10.3969/j.issn.1673-8225.2011.53.017 Abstract ( 329 )   PDF (1356KB) ( 600 )   Save BACKGROUND: Many experiments and clinical studies confirmed that astragalus and Xuebijing injections can strengthen body immunity and block inflammatory response in vivo, but there are no reporters on application of astragalus and Xuebijing injections for the infection after transplantation. OBJECTIVE: To observe the joint application effect of astragalus and Xuebijing injections on pulmonary infection after renal transplantation. METHODS: Totally 28 cases who suffered pulmonary infection within one year after renal transplantation and had no obvious improvement in clinical symptoms and imaging examination at 5 days after stop using immunosuppressant and received anti-infective treatment. These cases were divided randomly into two groups (14 for each), treatment group and control group, to receive immunization support therapy based on the conventional therapy. Conventional therapy included immunosuppressant adjustment, empirical anti-infection, selection of anti-infective agents according to drug sensitive result and other symptomatic treatments like sputum excretion, temperature reduction, and adjustment internal environment. For patients who suffered severe infection, ulinastatin and breathing machine were used to protect the functions of each organ and assist breathing. Immunization support included: astragalus injection and Xuebijing injection for the treatment group; human normal immunoglobulin for the control group by intravenous drip. RESULTS AND CONCLUSION: Compared with the number of lymph cells of CD3+CD4+ and CD3+CD8+ from the patients with treatment group before taking immunization support drugs, the lymph cells thereof obviously increased after 7 days. There was no significant difference in the improvement rate, the period from the time of admission to the time of getting better after infection, the average length of stay, the mortality rate and the incidence of acute rejection between the treatment group and the control group (P > 0.05). Jointly applying the astragalus and Xuebijing injections on the basis of the positive conventional therapy can promote the increase of CD3+CD4+CD8+, restore the overly inhibitory immunologic function at different levels and shorten the disorganization time adjusted by immunologic function to sustain the balance of immune inflammation regulatory function, improve prognosis, obtain the similar therapeutic effect of human normal immunoglobulin, and at the same time, the toxic side effect is small. Related Articles | Metrics

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Proteinuria after kidney transplantation Shen Bei-li, Yang Lei, Hu Jun-jie, Wang Su-jing, Xie Hong-mei, Guo Xiao-fang 2011, 15 (53):  9953-9956.  doi: 10.3969/j.issn.1673-8225.2011.53.018 Abstract ( 411 )   PDF (560KB) ( 532 )   Save BACKGROUND: Proteinuria directly correlates with long-term survival of transplanted kidney and is an independent risk factor influencing long-term survival of transplanted kidney and leading to death of transplant patients. OBJECTIVE: To investigate the effects of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides in treatment of proteinuria after kidney transplantation. METHODS: Forty-five patients presenting with proteinuria after kidney transplantation were divided into three groups: treatment, tripterygium glycosides group and control. In the treatment group, based on conventional application of immunosuppressive agent, 2-fold dose of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides (1 mg/kg per day) were used. In the tripterygium glycosides group, tripterygium glycosides (1 mg/kg per day) was used. In the control group, only immunosuppressive agent was used. RESULTS AND CONCLUSION: At 12 months after treatment, 24-hour urine protein, ciclosporin A concentration, ciclosporin A dosage were significantly lower in the treatment and tripterygium glycosides groups than in the control group (P < 0.05). After treatment, urea nitrogen and creatinine levels in the treatment group were significantly lower than those in the control and tripterygium glycosides groups (P < 0.05). These findings suggest that angiotensin Ⅱ receptor blocker combined with tripterygium glycosides can obviously decrease urine protein level after kidney and reduce immunosuppressive agent application dose, exhibiting a protective effect on transplanted kidney. Related Articles | Metrics

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Clinical significance of CD4+ and CD8+ T cell subset counts in renal allograft recipients Xiong Hai-yun, Zhang Lei, Wang Li-ming, Zhao Wen-yu, Yuan Qing, Chen Yu, Zhou Lin, Zhang Ling-zhen, Zhu You-hua 2011, 15 (53):  9957-9960.  doi: 10.3969/j.issn.1673-8225.2011.53.019 Abstract ( 382 )   PDF (699KB) ( 2025 )   Save BACKGROUND: In the clinic, the ratio of peripheral blood CD4+ to CD8+ T cell subset counts determined by flow cytometry is often used to reveal the relationship related to rejection or infection. OBJECTIVE: To investigate the value and significance of peripheral blood CD4+ and CD8+ T cell subset counts in patients suffering from rejection or infection after renal transplantation. METHODS: CD4+ and CD8+ T cell subset counts in 121 patients receiving renal transplantation were determined by flow cytometry. According to disease condition, patients were assigned to normal group, acute rejection group and pulmonary infection group. RESULTS AND CONCLUSION: There was no significant difference in CD4+ and CD8+ T cell subset counts between normal and acute rejection groups (P > 0.05). CD4+ and CD8+ T cell subset counts were significantly reduced in the pulmonary infection group than in the normal group (P < 0.001). When infection was controlled and symptoms were improved, CD4+ and CD8+ T cell subset counts were significantly increased (P < 0.001). These findings suggest that CD4+ and CD8+ T cell subset counts can be used as a reference of immune state in renal allograft recipients, they are more valuable in considering patients with infection than patients with rejection, and serial observation of CD4+ and CD8+ T cell subset counts may be very useful in optimizing treatment. Related Articles | Metrics

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Security for adenovirus-mediated p53 gene transfer to the donor heart Wang Li-ping, Song Fang-fang, Li Xiang-lu, Liu Yue, Jia Zhi-bo, Yin Xin-hua 2011, 15 (53):  9961-9964.  doi: 10.3969/j.issn.1673-8225.2011.53.020 Abstract ( 332 )   PDF (726KB) ( 510 )   Save BACKGROUND: Wild-type p53 gene transfer to the donor heart can greatly inhibit graft coronary artery intima hyperplasia and lumen narrowness. OBJECTIVE: To study the security of adenoviral-mediated wild-type p53 gene transfer to the donor heart after heart transplantation. METHODS: Rat models of heterotopic (abdomen) heart transplantation were developed. Wistar rats served as donors and SD rats as recipients. After donor hearts were removed, 800 µL adenoviral vector encoding the wild-type p53 gene (Ad-p53 group), adenoviral vector encoding the β-galactosidase gene (LacZ) (Ad-LacZ group) or saline (control group) were infused into the donor heart respectively before transplantation. The donor heart was stored in the 4 ℃ saline for 30 minutes before heart transplantation. At 5 days after operation, P53 protein expressions in coronary artery of donor hearts were tested by western blot analysis. At 28 days after transplantation, the serum specimen was collected for the biochemical indicators, and the major organs of the recipients were tested by the histopathological analysis and the reverse transcription polymerase chain reaction of the adenoviral E1A sequences. RESULTS AND CONCLUSION: The expression of P53 protein was found in donor hearts in Ad-p53 group at 5 days after operation, and no expression in Ad-LacZ group and control group. At 28 days after operation, rat serum biochemistry values in three groups was normal, the major organs of the recipients were not affected seriously, no virus spread to other organs in this experimental protocol. The results confirmed that the ex vivo adenoviral-mediated gene transfer to the donor heart via the coronary artery during the heart transplantation is safe. Related Articles | Metrics

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Cryopreservation of the lung from a non-hear-beating donor Dong Qing, Cui Jian, Han Jing-quan, Yan Yu-bo, Cao Shou-qiang, Zhang Kai 2011, 15 (53):  9965-9968.  doi: 10.3969/j.issn.1673-8225.2011.53.021 Abstract ( 371 )   PDF (551KB) ( 403 )   Save BACKGROUND: There are two ways to cryopreserve the lung from non-heart-beating donors: one is in situ thoracic cavity internal surface cooling technique, which has been confirmed by successful transplantation in the clinic, and the other is in situ endotracheal venting cooling technique. OBJECTIVE: To evaluate the feasibility of combining in situ thoracic cavity internal surface cooling technique with in situ endotracheal venting cooling technique in cryopreserving the lung from non-heart-beating donor. METHODS: Wister rats were randomly divided into three groups: in situ endotracheal venting hypothermy group (venting group), cool gas was insufflated into the trachea; in situ thoracic cavity internal surface hypothermy group (surface group): cool physiological saline was persistently injected into bilateral thoracic cavity; and combination group: cool gas insufflation combined with physiological saline injection into bilateral thoracic cavities RESULTS AND CONCLUSION: The combination group produced better effects than the surface group and venting group (P < 0.05), and the temperature of trachea and lung parenchyma could be lowered to preservation temperature within 60 minutes. These findings suggest the feasibility of in situ thoracic cavity internal surface cooling technique and in situ endotracheal venting cooling technique used in lung transplantation. Related Articles | Metrics

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Effect of tripterygium glycosides on pulmonary transplantation rejection of syngeneic rats Piao Tie-hua, Gu Yue, Cai Hong-yan, Xi Zhong-yuan 2011, 15 (53):  9969-9972.  doi: 10.3969/j.issn.1673-8225.2011.53.022 Abstract ( 248 )   PDF (562KB) ( 509 )   Save BACKGROUND: Tripterygium wilfordii is woodiness lianas of celastraceae and has been proved to possess immunosuppression. Tripterygium wilfordii can be used as immunomodulator after lung transplantation. OBJECTIVE: To study the inhibition of tripterygium glycosides against acute rejection after lung transplantation of rats and its effect on the intercellular adhesion molecule 1 (ICAM-1) level and the number of activated T cells in the peripheral blood. METHODS: Fifty Sprague Dawley rats were selected randomly and divided into 3 groups: the blank group, the control group and the treatment group. Normal rats were the blank group. Lung orthotopic transplantation models were established by the modified “cuff-like” vessel anastomosis technique in the rats of the control group and the treatment group. After surgery, the blank group and the control group were irrigated the rat stomach with normal saline at 1 mL/d, while the treatment group was treated with tripterygium glycosides at 50 mg/kg/d for 5 days. RESULTS AND CONCLUSION: The rejection grade of lung transplantation of the treatment group was significantly lower than that of the control group (P < 0.01); the number of CD25+T cells and the ICAM-1 level in the peripheral blood of the treatment group were higher compared with the blank group (P < 0.05), and lower than those of the control group (P < 0.05). Tripterygium glycosides may reduce the peripheral CD25+T cells and antagonize the ICAM-1 in lung tissues to inhibit the acute rejection after lung transplant in rats. Related Articles | Metrics

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Effects of species, development periods and different experimental conditions on the outcomes of embryo freezing and thawing in cleavage stage Gong Xiao-yun, Zhao Jing, Hu Bo, Wang Peng, Cai Xia 2011, 15 (53):  9973-9976.  doi: 10.3969/j.issn.1673-8225.2011.53.023 Abstract ( 276 )   PDF (648KB) ( 392 )   Save BACKGROUND: In the studies of frozen-thawed human cleavage embryos, whether the experimental conditions and experimental animal model have the same sensitivity with human to reflect the experiment quality is worth exploring. OBJECTIVE: To investigate the effects of embryo species, development periods and different frozen conditions on the outcomes of embryo freezing and thawing in cleavage stage. METHODS: Human embryos in cleavage stage served as control group, KM mouse embryos were randomly divided into 2-cell-stage group, 4-cell-stage group and 8-cell-stage group. Experiment scheme: Operating environment temperature were 18-20 ℃, 24-26 ℃ and 37 ℃. Slow programmed cryopreservation, self-made Straw-leaf vitrification cryopreservation and close pulled straw vitrification cryopreservation were used in this study. Contact durations of vitrified solution were less than 40 seconds, 40-60 seconds and 60-90 seconds. The embryo survival rates and developmental rates after cultivating for 24 hours were compared among groups. RESULTS AND CONCLUSION: The survival rate of control group under the environment temperature of 24-26 ℃ was higher than that of 37 ℃ temperature (P < 0.05). The survival rate of control group and 4-cell-stage group by self-made Straw-leaf vitrification cryopreservation was higher than that of the two groups by slow programmed cryopreservation (P < 0.05). The embryo developmental rates after cultivating for 24 hours showed no significant difference (P > 0.05). There was no significant difference in embryo survival rates among groups with different contact durations of vitrified solution (P > 0.05). These findings suggest that the cleavage embryo resuscitation effect of vitrification is better than that of slow recovery process. Under the temperature of 24-26 ℃, the outcomes of embryo freezing and thawing can be improved by reducing cryoprotectant dose and contact duration. Different embryo species and developmental stages may produce different outcomes under the same conditions. Compared with other stages of embryo development, 4-cell mouse embryo is a more suitable experimental model for the freezing and thawing studies of human cleavage stage embryos. Related Articles | Metrics

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Different combinations and doses of hormone influence the superovulation of different mouse strains Qiu Ze-wen, Jiang Wu-qi, Gao Li-bo, Luo Guang-bin, Chen Jun, Zhan Hong-wei, Gao Wen-ting, Wang Jing-yu 2011, 15 (53):  9977-9980.  doi: 10.3969/j.issn.1673-8225.2011.53.024 Abstract ( 333 )   PDF (500KB) ( 840 )   Save BACKGROUND: Superovulation is affected by many factors, such as animal strain, nutritional level, age, stage of estrous cycle, light, method, hormone kind and dose used in superovulation. Hormone dose and animal strain are key factors among them. OBJECTIVE: To explore the effects of different dosage combinations of pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (HCG) on the superovulation outcome in different mouse strains. METHODS: Different dosage combinations of PMSG and HCG were used to treat ICR, KM and BALB/c mice for superovulation, respectively. The total number of embryos, the average number of embryos, the number of good embryo and the rate of good embryo were compared among different mouse strains treated with hormone. RESULTS AND CONCLUSION: Dosage combination of 5 IU PMSG+7 IU HCG was the best hormone combination for ICR and KM mice, while the best hormone combination for BALB/c mice was 3 IU PMSG+5 IU HCG. When these three mouse strains were treated by 5 IU PMSG+7 IU HCG, the average number of embryo and the rate of good embryo of ICR and KM mice were significantly higher than that of the BALB/c mice (P < 0.05). These findings demonstrate that in order to obtain more embryos for relevant experiments, ICR and KM mice and their inbred strains should be used for superovulation, especially the internationally used ICR mice. Related Articles | Metrics

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Correlation between renal arterial hemodynamic alterations and renal functions evaluated by color Doppler ultrasound using a rabbit renal ischemia reperfusion model Xuan Ji-qing, Peng Li-qing, Li Ming-xing, Li Kun-ping, Luo Zhi-jian 2011, 15 (53):  9981-9985.  doi: 10.3969/j.issn.1673-8225.2011.53.025 Abstract ( 346 )   PDF (1593KB) ( 585 )   Save BACKGROUND: Previous diagnosis of renal ischemia reperfusion mainly depends on biochemical and pathological examination. Color Doppler flow imaging (CDFI) can mini-invasively rapidly display renal blood flow changes following renal ischemia/reperfusion injury.  OBJECTIVE: To evaluate rabbit renal arterial hemodynamical changes after renal ischemia reperfusion using CDFI, and analyze the correlation between arterial hemodynamical changes and renal function indices including blood urea nitrogen (BUN) and creatinine (Cre). METHODS: Fifty-six rabbits were randomly divided into normal control group, ischemia reperfusion group and sham operation group. Rabbits were established into renal ischemia reperfusion models in the ischemia reperfusion group. Rabbits in the sham operation group underwent resection of the right kidney. No treatment was performed in the control group. According to different time points, three subgroups were used in the former two groups. RESULTS AND CONCLUSION: With aggravation of renal ischemia reperfusion injury, the systolic velocity, pulsatility index, resistance index and BUN and Cre were gradually increased and reached the peak at 24 hours. Hemodynamical changes first appeared in the interlobar artery. Resistance index is the most sensitive index to reflect the degree of renal ischemia reperfusion injury. CDFI is an effective method to evaluate renal ischemia/reperfusion injury degree. Related Articles | Metrics

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Effects of RelB shRNA lentivirus infection on immunological response of mouse bone marrow dendritic cells Xie Jin-min, Bao Jie, Dong Rui-qiang, Yang Ming, Wen Hao 2011, 15 (53):  9986-9990.  doi: 10.3969/j.issn.1673-8225.2011.53.026 Abstract ( 387 )   PDF (1684KB) ( 417 )   Save BACKGROUND: Whether nuclear factor-kappa B/RelB, a key gene to maturation of silenced dendritic cells, can construct novel tolerogenic dendritic cells remains poorly understood? OBJECTIVE: To investigate the effects of RelB shRNA lentivirus infection on immunological response of mouse bone marrow derived bone marrow dendritic cells. METHODS: Mouse bone marrow derived dendritic cells were cultured with recombinant mouse granulocyte-macrophage colony-stimulating factor (rmGM-CSF) and recombinant mouse interleukin-4 (rmIL-4). RelB shRNA lentivirus was transfected into mouse bone marrow derived bone marrow dendritic cells and then divided into four groups for observation: immature dendritic cells, mature dendritic cells stimulated by lipopolysaccharide, RelB-silenced dendritic cells, and RelB-silenced dendritic cells stimulated by lipopolysaccharide. RESULTS AND CONCLUSION: After 6 days of in vitro culture, in the group of mature dendritic cells stimulated by lipopolysaccharide, a large number of slender branch-like processes on the cell surface; in the other three groups, cell morphology was similar, exhibiting a round and shrunk appearance, and MHC-II molecule, CD86 and CD40 expression levels were similar, but they were lower compared with the group of mature dendritic cells stimulated by lipopolysaccharide. There was no significant difference in ability to stimulate T cell stimulation among the latter three groups, but the ability in these three groups was significantly lower than that in the group of mature dendritic cells stimulated by lipopolysaccharide (P < 0.01). RelB-silenced dendritic cells showed poor ability to secrete Th1 cytokineγ- interferon and IL-2 and strong ability to secrete Th2 cytokine IL-10 and IL-4 (P < 0.01). The proportion of Th1/Th2 cytokines was similar between the group of RelB-silenced dendritic cells and group of immature dendritic cells. These findings suggest that after RelB shRNA lentivirus infection, bone marrow-derived dendritic cells exhibit similar cell morphology, surface molecule expression and immunological function to immature dendritic cells and cannot be stimulated by lipopolysaccharide to develop into mature cells. Related Articles | Metrics

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Effect of sensitized dendritic cells with kinectin-maltose-binding protein on T cell differentiation activity Zhao Fei-lan, Chao Nai-xia,Li Ri-lun, Zeng Qing-tang, Huang Tian-ming, Mo Fa-rong, Xiao Fei, Luo Guo-rong 2011, 15 (53):  9991-9995.  doi: 10.3969/j.issn.1673-8225.2011.53.027 Abstract ( 323 )   PDF (1446KB) ( 379 )   Save BACKGROUND: Kinectin, as a dendritic cell tumor seed, can be used for clinical immunotherapy of hepatocellular carcinoma. OBJECTIVE: To evaluate the effect of kinectin-maltose-binding protein (MBP)-sensitized dendritic cells (DC) on autologous T cell differentiation activity. METHODS: The proliferation of CD4+, CD8+ T cell subset stimulated by DC incubated with kinectin-MBP was detected by immunohistochemistry. Simultaneously, kinectin-MBP, non-sensitized DC, and commonly cultured T cells groups were set for comparison. RESULTS AND CONCLUSION: The number of CD8+ T cells was increased significantly in the kinectin-MBP-DC-T cell group than in the kinectin-MBP, non-sensitized DC, and commonly cultured T cells groups (P < 0.05). There was no significant difference in the number of CD+ T cells and the ratio of CD4 to CD8 among the groups (P > 0.05). The results showed that kinectin-MBP-sensitized DC can effectively stimulate the proliferation of autologous CD8+ T cells and kinectin-MBP as a hepatocellular carcinoma-related antigen can exert obvious anti-tumor function via the sensitized DC. Related Articles | Metrics

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Establishment of a porcine beating heart model in vitro Zheng Min, Song Jian-fei, Yang Feng, Zhang Wen-bin 2011, 15 (53):  9996-9998.  doi: 10.3969/j.issn.1673-8225.2011.53.028 Abstract ( 404 )   PDF (989KB) ( 358 )   Save BACKGROUND: Keeping beating of the donor heart can reduce its ischemia time and prolong its preservation time in vitro. OBJECTIVE: To establish a simple and stable model of porcine beating heart in vitro. METHODS: Twelve healthy pigs were randomly divided into beating group and cold crystalloid perfusion group. In the beating group, coronary perfusion was established through the ascending aorta, venous drainage was established through right atrium into the right ventricle, the hose was placed into the left ventricle through the left atrial appendage for drainage, and then the model of porcine beating heart in vitro was established. Heart protection in vitro was performed in the cold crystalloid perfusion group after normal heart transplantation. RESULTS AND CONCLUSION: Surgery in vitro of porcine heart was successfully performed on six pigs of the beating group. The success rate of beating heart was 100% after 2 and 4 hours of surgery, and was 83% at 6 hours. The malondialdehyde levels were decreased, superoxide dismutase activities were increased (P < 0.05), and the myocardial ultrastructure was well kept in the beating group compared with the cold crystalloid perfusion group. The porcine beating heart model has a high success rate in modeling, and it is an ideal animal model for studying beating heart in vitro. Related Articles | Metrics

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Effect of exogenous antigen on expression of major histocompatibility complex class I chain-related gene A in endothelial cells Wang Yun-yan, Hou Jian-quan, He Jun, Yuan Xiao-ni, Zhang Jiang-lei, Wen Duan-gai 2011, 15 (53):  9999-10002.  doi: 10.3969/j.issn.1673-8225.2011.53.029 Abstract ( 376 )   PDF (378KB) ( 453 )   Save BACKGROUND: Studies have demonstrated that incidence rate of acute rejection in renal transplant recipients with pre-production of major histocompatibility complex class I chain-related gene A (MICA), including parts of autoantibody, before transplantation in body, is obviously greater than that of recipients with negative antibody.  OBJECTIVE: To investigate effects of exogenous antigen on MICA expression in endothelial cells. METHODS: The endothelial cells were cultured with exogenous recombinant MICA protein (group M5, M10 and M25) and heat shock protein-70 (group H5, H10 and H25) with dosages of 5, 10 and 25 μg/L, respectively, for 48 hours. Same volume of phosphate buffer saline was added into the control groups.  RESULTS AND CONCLUSION: At 48 hours after induction, the expressions of MICA mRNA and protein were increased significantly in each experimental group (M5, M10 and M25) than that of the control group with significant (P < 0.05). The expression of MICA mRNA and MICA protein of group M5 and group M10 were remarkably higher than group M25 (P < 0.05); however, there was no significant difference between group M5 and M10 (P > 0.05). The expression of MICA membrane protein in the group M10 was obviously greater than that of the group M5 and M25 (P < 0.05). The level of soluble MICA (sMICA) in experimental groups (M5, M10 and M25) was decreased obviously comparing with that of the control group. These differences had statistical significances (P < 0.05). But there was no significant difference among the experimental groups (P > 0.05). However, the expression of MICA gene and sMICA level did not change after heat shock protein-70 stimulation. The exogenous MICA antigen up-regulates the expression of MICA mRNA and protein, especially increases the expression of membrane protein on the cell surface significantly, but sMICA in supernatant was dramatically decreased. Related Articles | Metrics

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Effects of tacrolimus on the proliferation of HepG2.2.15 cells and the replication of hepatitis B virus in vitro Wang Jian, Shen Zhong-yang, Song Hong-li, Zheng Wei-ping, Song Xiao-jing 2011, 15 (53):  10003-10006.  doi: 10.3969/j.issn.1673-8225.2011.53.030 Abstract ( 344 )   PDF (369KB) ( 440 )   Save BACKGROUND: The relationship between liver cancer recurrence and hepatitis B virus recurrence remains poorly understood and it is considered to be related to application of immunosuppressive agent after liver transplantation. OBJECTIVE: To investigate the effects of tacrolimus (FK506) on the proliferation of HepG2.2.15 cells and the replication of hepatitis B virus in vitro. METHODS: HepG2.2.15 cells were in vitro cultured. After passage 3 HepG2.2.15 cells were cultured for 24 hours, they were interfered with different concentrations of FK506. 0 g/L FK506-interfered group served as control group, 50 g/L FK506-interfered group as low-concentration FK506 group, 100 g/L or 500 g/L FK506-interfered group as medium-concentration FK506 group, and 1 000 g/L or 3 000 g/L FK506-interfered group as high-concentration FK506 group. RESULTS AND CONCLUSION: Moderate- and high-concentration FK506 exhibited inhibitory effects on the proliferation of HepG2.2.15 cells, while low-concentration FK506 exhibited no inhibitory effects with correlation. High-concentration FK506 made HepG2.2.15 cells arresting at G0/G1 stage. FK506 decreased CyclinA expression in HepG2.2.15 cells in a dose-dependent manner. Higher concentration of FK506 leaded to lower expression of CyclinA. FK506 did not produce effects on the replication of hepatitis B virus in HepG2.2.15 cells. These results indicate that FK506 inhibits the proliferation of HepG2.2.15 cells in vitro, which occurs possibly due to Cyclin A, but it would not affect the replication of hepatitis B virus in vitro. Related Articles | Metrics

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Effect of nasal tolerance induction to heat shock protein-65 on atherosclerosis and potential mechanism Li Hai-yu, Ding Yan-ping, Zeng Qiu-tang 2011, 15 (53):  10007-10010.  doi: 10.3969/j.issn.1673-8225.2011.53.031 Abstract ( 396 )   PDF (757KB) ( 529 )   Save BACKGROUND: A body of evidences support that CD4+CD25+Foxp3+ regulatory T cells is associated with oral tolerance induction and inhibition of atherosclerosis, but little is described whether nasal tolerance to antigen likewise induce the regulatory T cell production and antiatherosclerotic benefit. OBJECTIVE: To investigate the effect of nasal tolerance induction to heat shock protein-65 (HSP65) on atherogenesis and potential mechanism. METHODS: Six-week-old male ApoE-/- mice were nasally administrated HSP65 or phosphate buffer as control. Cryo-section was used to examine the size of atheromatous plaque area of aortic root in ApoE-/- mice with sixteen-week-old; fluorescence activated cell sorter was used to analyse the production level of CD4+CD25+Foxp3+ regulatory T cells; ELISA was applied to determine the level of cytokines transforming growth factor beta (TGF-β). RESULTS AND CONCLUSION: Eight weeks after nasal administration, the results of cryo-section showed that HSP65-treated mice had a marked decrease by 32.7% in atheromatous plaque area of aortic root as compared with the control group (P < 0.01). At 14 days after the last nasal treatment, the percentage of CD4+CD25+Foxp3+ regulatory T cells in total CD4+ T cells from treated mice increased significantly as compared with the control group (P < 0.01), at 4,14 days and 8 weeks after the last nasal administration, cytokine TGF-β level from nasal HSP65 mice increased remarkably compared with the control group on the above three points. So, nasal tolerance induction to heat shock protein-65 inhibits atherosclerotic formation by inducing anti-inflammatory cytokine TGF-β-dependent regulatory T cells. It is proposed that nasal tolerance induction to HSP65 may provide an alternative therapeutic method to atherosclerosis. Related Articles | Metrics

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Activity of nuclear factor-kappa B in peripheral blood mononuclear cells of diabetes patients at different levels of blood glucose control with maintenance hemodialysis Wang Jing-fu, Xing En-hong, Duan Shu-zhong, Zhang Kun, Guo Feng-ling, Zhao Ya-juan, Hu Gui-cai 2011, 15 (53):  10011-10015.  doi: 10.3969/j.issn.1673-8225.2011.53.032 Abstract ( 267 )   PDF (457KB) ( 460 )   Save BACKGROUND: Abnormal activation of nuclear factor-kappa B (NF-κB) and protein kinase C signal transduction pathway is the central link of occurrence and development of diabetes mellitus and related complications. OBJECTIVE: To investigate the NF-κB activity in peripheral blood mononuclear cells (PBMC) in diabetes patients of different levels of blood glucose control with maintenance hemodialysis and investigate the relationship of NF-κB activity with glycosylated hemoglobin (HbAlc) and high sensitive C reactive protein (hs-CRP) levels and malnutrition. METHODS: The indices of 71 chronic renal failure uremia patients with maintenance hemodialysis were analyzed through cross-sectional study. Twenty-two diabetic nephropathy patients with maintenance hemodialysis were divided into good control of blood glucose group (n=12) and poor control of blood glucose group (n=10). The other 49 non-diabetic nephropathy patients with maintenance hemodialysis were taken as control group. RESULTS AND CONCLUSION: The serum albumin and serum prealbumin levels of patients in the poor control of blood glucose group were significantly lower than those in the good control of blood glucose group and non-diabetic nephropathy group.The serum hs-CRP level and NF-κB activity of patients in poor control of blood glucose group were significantly higher than those in the good control of blood glucose group and non-diabetic nephropathy group. HbAlc was positively correlated with serum hs-CRP level and NF-κB activity and was negatively correlated with serum albumin and serum prealbumin. NF-κB activity was positively correlated with hs-CRP levels and was negatively correlated with serum albumin and serum prealbumin. The results suggest that poorer control of blood glucose in diabetic nephropathy patients with maintenance hemodialysis leads to stronger NF-κB activity, more obvious inflammatory reaction and more severe malnutrition. Abnormal activation of NF-κB induced by poor control of blood glucose is one of the main reasons that aggravate inflammatory reaction and malnutrition for diabetes patients with maintenance hemodialysis. Related Articles | Metrics

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Peribiliary vascular plexus damage and biliary complications after liver transplantation Zhu Feng, Ai Qiu-bao, Zhang Cheng-hua 2011, 15 (53):  10018-10022.  doi: 10.3969/j.issn.1673-8225.2011.53.034 Abstract ( 352 )   PDF (609KB) ( 432 )   Save BACKGROUND: With an obvious decrease in biliary complications caused by pure bile duct anastomosis after liver transplantation, ischemic biliary damage caused by damage to arterial blood supply due to various factors should be paid more attention. OBJECTIVE: To summarize the anatomical structure of bile duct, physiological morphology of peribiliary vascular plexus, mechanisms underlying the damage to peribilary vascular plexus caused by liver transplantation and resultant biliary complications and how to prevent the damage to peribiliary vascular plexus. METHODS: A computer-based online search of PubMed, CNKI, VIP and Wanfang databases was performed for relative articles about liver transplantation and peribiliary vascular plexus published before December 2010, with key words of “liver transplantation, peribiliary vascular plexus, biliary complications, microcirculation of bile duct, ischemia-reperfusion injury” in English and in Chinese by screening titles and abstracts. The contents of the article associated with liver transplantation and peribiliary vascular plexus were selected, and those published recently or in authoritative journals were preferred in the same field. RESULTS AND CONCLUSION: Totally 228 articles were obtained in initial retrieval, 23 articles of them were chosen to summarize based on inclusion criteria. The peribiliary vascular plexus was primarily composed of hepatic artery terminal branches, which provide bile duct blood supply and nutrition. The biliary tree was damaged by various factors in liver transplantation, and most factors directly or indirectly act on the peribiliary vascular plexus, leading to biliary complications. References | Related Articles | Metrics

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Application of immunosuppressants in graft rejective reaction Zhang Xiao-li, Xu Ying, Li Yong 2011, 15 (53):  10023-10026.  doi: 10.3969/j.issn.1673-8225.2011.53.035 Abstract ( 463 )   PDF (699KB) ( 619 )   Save BACKGROUND: Organ transplant patients require lifelong use of immunosuppressive reagent, so a rational use of immunosuppressive agents is the key to organ transplantation. OBJECTIVE: To summarize various representative drugs in organ transplantation and to propose a suitable immunosuppressive agent for organ transplant patients. METHODS: The first author searched PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang Database (http://www.wanfangdata.com.cn) from 1999-01/2011-06. English key terms are “immunosuppressive drug, reject reaction, cyclosporine A, tacrolimus (FK506)”, and Chinese key terms are “immunosuppressive drugs, renal transplantation, liver transplantation, rejection”. A total of 105 documents were screened out, and those focusing on the application and clinical effectiveness of different immunosuppressive drugs in organ transplantation were included, while repeated experiments and old articles were excluded. Recently published articles or those published in the authority magazine were preferred in the same field, ultimately 20 literatures were involved in the final analysis. RESULTS AND CONCLUSION: Common immunosuppressive drugs include the adrenal cortical hormone, metabolic antagonists, and T lymphocyte inhibitor. However, each immunosuppressant has certain toxic side effects when they are playing immunosuppressive effects, so side effects should be avoided. How to exhibit the synergic effect between the immunosuppressive drugs and to achieve the best clinical efficacy needs further attention. We should closely monitor blood concentration and give individual drug therapy, so as to lower incidence of toxic side effects. Related Articles | Metrics

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Infection and rejection after small intestine transplantation Chen Yuan-chong 2011, 15 (53):  10027-10030.  doi: 10.3969/j.issn.1673-8225.2011.53.036 Abstract ( 316 )   PDF (718KB) ( 351 )   Save BACKGROUND: Small intestine transplantation has been conducted in some transplantation centers of China and obtained favorable short-term effects. However, complications are critical for success of transplantation, and effective prevention and early treatment of complications are important for small intestine transplantation. OBJECTIVE: To discuss causes for posttransplant infection and rejection and prevention measures. METHODS: With key words “Small bowel transplantation; Liver bowel transplantation; Rejection; Immunosuppressive; Infection” in English and Chinese, a computer-based online search of Medline and CNKI was performed for articles related to infection and rejection after small intestine transplantation published between January 2000 and June 2011. A total of 25 articles were included. RESULTS AND CONCLUSION: The small intestine contains abundant lymphatic tissues and a large number of immune competent cells. Moreover, there are a large amount of microorganisms in the enteric cavity, inducing high incidence of rejection and infection following transplantation. Reduction of complications is based on prevention and treatment time. Monitor of cytokines changes can prevent rejection following small intestine transplantation. Related Articles | Metrics

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Clinical application of human hepatocyte transplantation Ran Jiang-hua, Liu Jing, Li Li, Li Shi-feng 2011, 15 (53):  10031-10034.  doi: 10.3969/j.issn.1673-8225.2011.53.037 Abstract ( 260 )   PDF (461KB) ( 336 )   Save BACKGROUND: Now, source of human hepatocyte is mainly from the marginal donor liver that unused or deemed unsuitable for liver transplantation. Hence the major obstacle for the wide clinic application of human hepatocyte transplantation is the limited supply of donor liver that can provide good quality cells. OBJECTIVE: To review the clinical actuality and challenge of human hepatocytes transplantation and to summarise the clinical application and difficulty of human hepatocytes transplantation. METHODS: Wanfang, VIP and PubMed databases were searched from January1990 to September 2010 for literatures concerning human hepatocyte transplantation with the key words of “hepatocyte, transplant, liver failure, hepatocyte source” or “hepatocyte transplantation; liver failure; liver-based metabolic disorders” in Chinese and in English. The articles related to the research on the human hepatocyte transplantation were selected; articles in the same circle published in recent years or in authorized journals. Older articles and repetitive studies were excluded. RESULTS AND CONCLUSION: Among 213 articles, only 30 met the requirement. Over 80 patients have received human hepatocyte transplantation to treat liver-based metabolic disorders and liver failure around the world. After transplantation, it has shown some early improvement in liver function which showed that hepatocyte transplantation has a wide clinical application. The major challenge is to develop an alternative source of hepatocytes and the survival course of human hepatocytes transplanted into donor liver also need to further improve. Related Articles | Metrics

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Effects of different preservation methods on the immunogenicity of cartilage allografts in the repair of cartilage defects Wang Li-xia, Li Min, Zhang Rui-cun, Wang Ai-bo 2011, 15 (53):  10035-10038.  doi: 10.3969/j.issn.1673-8225.2011.53.038 Abstract ( 344 )   PDF (669KB) ( 454 )   Save BACKGROUND: Immune rejections still exist in the allograft cartilage transplantation for repair of cartilage defects. OBJECTIVE: To evaluate the effects of programmed cryopreservation method, cryoprotective agent process for cooling preservation, tissue culture method, and chemical treatment on the immunogenicity of cartilage allografts in the repair of cartilage defects. METHODS: An electronic search of Wanfang and PubMed was performed for articles about effects of different preservation methods on the immunogenicity of cartilage allografts in the repair of cartilage defects published 1998-01/2011-11. The keywords were “cartilage, preservation, transplantation”. Repetitive studies, reviews and Meta analysis were excluded, and finally 36 articles were included. RESULTS AND CONCLUSION: Chondrocyte membrane has histocompatibility antigens, and chondrocytes can be expressed in the major compatibility complex with specific differentiation antigens. When the matrix is tact, the cartilage cells cannot touch receptor lymphocytes and plasma cells, showing a low immunity, but the subchondral bone was not covered with the matrix. As a result, the cartilage allografts with the subchondral bone can immunogenicity, though the fixation can be strengthened. The programmed cryopreservation method, cryoprotective agent process for cooling preservation, and tissue culture method have achieved good effects on the immunogenicity of cartilage allografts in the repair of cartilage defects. Related Articles | Metrics

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Immune rejection following anterior cruciate ligament reconstruction with tendon allograft Zuo Jian, Sun Hao, Pan Le 2011, 15 (53):  10039-10042.  doi: 10.3969/j.issn.1673-8225.2011.53.039 Abstract ( 448 )   PDF (536KB) ( 404 )   Save BACKGROUND: In recent years, tendon allograft is gradually used for repair of anterior cruciate ligament injury. OBJECTIVE: To review the characteristics of anterior cruciate ligament injury and immune rejection following anterior cruciate ligament reconstruction with tendon allograft. METHODS: A computer-based search of PubMed and VIP databases (1990-01/2011-10) was performed for relevant articles using the keywords of “anterior cruciate ligament, allograft, anatomy, transplantation” in English and “anterior cruciate ligament, allograft, tendon, transplantation” in Chinese. Totally, 164 articles were retrieved, and finally 34 articles were included in result analysis. RESULTS AND CONCLUSION: Over the past several decades, domestic and foreign scholars have studied anterior cruciate ligament reconstruction with tendon allograft and gradually understood the biomechanical properties of the anterior cruciate ligament. Freezing method and cell toxic treatment method are employed to solve the immune rejection following allogeneic tendon grafting, not only to reduce the antigenicity of allogeneic tendon, but also to save the activity of tendon cells, promote endogenous tendon healing, improve tendon healing and strength, reduce or avoid the occurrence of tendon adhesions, and achieve good clinical results. Related Articles | Metrics

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Allogeneic tendon graft for repair of sports injuries: Immune rejection and methods to reduce immune rejections Pan Le, Li Shi-guang, Zuo Jian 2011, 15 (53):  10043-10046.  doi: 10.3969/j.issn.1673-8225.2011.53.040 Abstract ( 335 )   PDF (820KB) ( 466 )   Save BACKGROUND: Allogeneic tendons are of plenty source and easy to obtain, which maintain the original biological characteristics structure and meet the requirements for physique and quantity. However, untreated tendon allograft has a great immune rejection after transplantation. OBJECTIVE: To evaluate the repair effect of allogeneic tendon graft, and to summarize the methods to reduce immune rejections. METHODS: A computer-based search of Wanfang database was performed for articles published 1990-01/2011-11 addressing the immune rejection and methods to reduce the immune rejection after the allogeneic tendon graft for repair of sports injuries. The keywords were “allogeneic, tendon, construction”. Repetitive studies, review and Meta analysis were excluded, and finally 33 articles were included. RESULTS AND CONCLUSION: Histocompatibility of allogeneic tendon graft is poor, leading to a strong immune rejection. The graft can have tendon necrosis, immune rejection and other negative phenomena after transplantation of an untreated allogeneic tendon, resulting in a higher rate of graft failure. Methods to reduce the immune rejection are mainly as follows: frozen allograft tendons, freeze-dried allograft tendon, tendon soaked in drugs, and radiation sterilization method to save the tendon. It is noted that immune rejection following allogeneic tendon graft is the most difficult clinical problem, but frozen allograft tendons and other methods are good to solve this problem, and play a good clinical effect. Related Articles | Metrics

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Conventional and new surgical approaches to liver transplantation Guo Ke-lei, Sun Xiao-bei, Li Yang, Chi Hui 2011, 15 (53):  10047-10051.  doi: 10.3969/j.issn.1673-8225.2011.53.041 Abstract ( 333 )   PDF (653KB) ( 609 )   Save BACKGROUND: Liver transplantation is an important method in the treatment of the end-stage liver diseases and hepatic carcinoma, but nowadays the donors are more and more decreased, which are the choke point of the liver transplantation. The development of the surgery approaches of the liver transplantation can support to utilize the grafts and broaden the donors effectively. OBJECTIVE: To provide references for the clinicians to carry out liver transplantation and study the approaches through reviewing the developments and characteristics of conventional and new surgical approaches in liver transplantation. METHODS: Pubmed database, CNKI database and some liver transplantation registries were retrieved for the relate literatures of surgery approaches published between January 1900 and January 2011. Then, 35 literatures of clinical studies, reviews and reports were analyzed. RESULTS AND CONCLUSION: Totally 1 251 articles were obtained in initial retrieval, of which 35 articles were chosen to be analyzed based on the inclusion criteria. Standard orthotopic liver transplantation and Piggyback liver transplantation were conventional, and new approaches were emerging. Split liver transplantation could be realized for providing a graft to two recipients. Living donor liver transplantation could be used flexibly and developed rapidly. Liver autotransplantation was very difficult in the techniques, so it was rarely used. Domino liver transplantation could be used to treat FAP effectively, but it was also rarely used due to difficulties in the technology. Hepatocytes transplantation and liver xenotransplantation were not sufficiently studied. Conventional surgical technologies have been well mastered because of the advantages in utilizing the grafts and extending the source of grafts. New approaches have broad application prospects, but need the breakthroughs in surgical techniques and basic research. Related Articles | Metrics

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Effectiveness and clinical value of Meek technique for the repair of burn wounds: A Meta-analysis Zhang Xian-fa, Liang Zi-qian, Zhao Xue-kai, Ding Hua-rong 2011, 15 (53):  10052-10055.  doi: 10.3969/j.issn.1673-8225.2011.53.042 Abstract ( 352 )   PDF (621KB) ( 640 )   Save BACKGROUND: There are many clinical reports on Meek technique for the treatment of major burn injuries. However, the advantages of Meek micrografting technique are still controversial compared with traditional skin graft methods. And most of the controlled clinical trials are performed in small sample size. Therefore the results are lack of convincing. OBJECTIVE: To assess the effectiveness and clinical value of Meek technique in the treatment of severe burn wounds. METHODS: An online search of Cochrane Library (2009, No.12), PubMed (1990/2010-12), Ovid Data (1966/2011-03), CBM (1979/2010), Wanfang Data (1982/2011) and CNKI (1979/2010) was performed for controlled clinical trials of Meek technique in the treatment of burn wounds. The data was analyzed using the RevMan 5.1 software after quality evaluation of methodology used in retained articles and data extraction. RESUITS AND CONCLUSION: A total of 10 controlled clinical trials involving 198 cases of severe burn patients were included. Compared with the control group, the wound healing time, skin graft integration time, operation time, number of operators, and the treatment expenses (1% total body surface area, TBSA) of Meek micrografting technique group were reduced significantly. It suggests that compared with traditional skin graft methods, Meek technique can significantly promote the burn wounds healing, reduce medical costs, shorten surgical operation and have high clinical application value. Related Articles | Metrics

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Transplantation of autologous dermal fat flap for introcession malformation of cleft lip Ma Fu-lian, Tang Yin-ke, Wang Wei, Gao Jin-li, Han Xiao, Zhai Xiao-mei 2011, 15 (53):  10056-10059.  doi: 10.3969/j.issn.1673-8225.2011.53.043 Abstract ( 396 )   PDF (563KB) ( 651 )   Save BACKGROUND: There are few reports on transplantation of autologous dermal fat flap for cleft lip deformity, but selection and repair effect both has obvious advantages. OBJECTIVE: To investigate application of autologous dermal fat flap transplantation on secondary cleft lip deformity repair, and evaluate and analyze the repair effect. METHODS: Retrospective analysis data of 91 patients whose secondary lip upper with different degrees of depression after autologous dermal fat flap from different parts used for lip transplantation. Eversion degree of lips on lips, survival and absorption of autologous dermal fat flap and repair effect of upper lip were observed. RESULTS AND CONCLUSION: Survival and absorption of dermal fat flap, eversion degree of lips on lips were observed at 6 months after repairing. Seventy-six in 91 cases were followed-up, 61 cases of composite dermal fat flap survived well and the effect was satisfactory. Four cases was severely absorption, 2 cases was filled with excessive dermal fat flap real flap and 9 cases were lacked of upper lip eversion, All the cases obtained satisfactory effect after repair again at 6 months. Tansplantation of autologous dermal fat flap for introcession malformation of cleft lip can obtain good effect in local defects depression. Related Articles | Metrics

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Repair of combined anterior cruciate ligament and posterolateral corner injury by tendon autograft Zhang Jian-lin, Luan Yan-jun, Guo Long, Xing Jun, Bai Li-bang, Jiang Peng-fei 2011, 15 (53):  10060-10063.  doi: 10.3969/j.issn.1673-8225.2011.53.044 Abstract ( 463 )   PDF (780KB) ( 619 )   Save BACKGROUND: Cruciate ligament and posterolateral corner of the knee can both be reconstructed by semitendinosus and gracilis tendon autograft. OBJECTIVE: To analyse the repairing effects of semitendinosus and gracilis tendon autograft on knee joint combined anterior cruciate ligament and posterolateral corner injury. METHODS: A total of 20 patients of knee joint combined anterior cruciate ligament and posterolateral corner injury were randomly assigned into experiment group and control group. With the aid of arthroscope, one-stage reconstruction of anterior cruciate ligament was performed by semitendinosus autograft and gracilis tendon autograft, and the reconstructed posterolateral corner was strengthened in the experiment group. Patients in control group only underwent one-stage reconstruction of anterior cruciate ligament. RESULTS AND CONCLUSION: Compared with preoperation, there was a significant improvement in Lysom scores of the two groups (P < 0.01). Experimental patients did not show over-extending knee instability related to unstable posterolateral structures of the knee joint when standing, walking, going upstairs and downstairs. There was no inward swing of the knee joint during walking. The ranges of motion were from 100° to 135° of flexion and from 0° to 10° of extension. There were 3 cases in the control group showed no over-extending knee instability related to unstable posterolateral structures of the knee joint when standing, walking, going upstairs and downstairs, and 4 cases showed slight inward swing of the knee joint during walking. The ranges of motion were from 104° to 130° of flexion and from 0° to 10° of extension. These findings demonstrate that the posterolateral, front and rear stability of the knee joint is recovered after the reconstruction of nterior cruciate ligament and posterolateral corner by tendon autograft. The treatment effect is better than the reconstruction of anterior cruciate ligament alone. Related Articles | Metrics

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Autologous hamstring grafts versus allogeneic anterior tibial muscle tendon grafts for arthroscopic reconstruction of single-bundle anterior cruciate ligament: A one-year follow-up Wang Hong, Meng Chun-qing, Duan De-yu, Yang Shu-hua, Du Jing-yuan, Tang Xin, Li Li-qun, Fang Qing, Tang Ming, Dhakal Rabi Mohan 2011, 15 (53):  10064-10067.  doi: 10.3969/j.issn.1673-8225.2011.53.045 Abstract ( 427 )   PDF (577KB) ( 854 )   Save BACKGROUND: Due to artificial ligament has chronic fatigue, more and more people use allograft for the reconstruction of anterior and the posterior cruciate ligament injury. OBJECTIVE: To compare the curative effect after arthroscopic reconstruction of single-bundle anterior cruciate ligament using autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts. METHODS: Cases of anterior cruciate ligament reconstruction which using single-bundle autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts under arthroscopic with 1 year follow-up were collected. Totally 28 cases were used autologous hamstring grafts for anterior cruciate ligament reconstruction, and 18 cases were used anterior tibial muscle tendon allograft for anterior cruciate ligament reconstruction. The fixation of each reconstructed anterior cruciate ligament was done by femoral EndoButton and tibial biodegradable interference screw. Using a brace to fix the troubled knee and having the physical training of the troubled knee lately and progressively. RESULTS AND CONCLUSION: All the 46 cases were followed up for six months after reconstruction. Lysholm score of the autologous tendon group was lower than that of the allogeneic tendon group (P > 0.05). There was no significant difference between the two groups of Lysholm score after six months postoperatively. Lysholm score of the two groups after 6 months and a year construction postoperative showed significant difference as compared with preoperation (P < 0.05). There was significant difference of  the Lysholm score after reconstruction in six months follow-up and in one year follow-up showing a statistic significance (P < 0.05). The curative effect of anterior cruciate ligament reconstruction using autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts is equally. Related Articles | Metrics

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One case of Penicillium marneffei infection after kidney transplantation Chen Tong-qing, Kong Yao-zhong, Luo Qi-wen, Lin Min-wa, Xu Jie-wei 2011, 15 (53):  10068-10070.  doi: 10.3969/j.issn.1673-8225.2011.53.046 Abstract ( 366 )   PDF (581KB) ( 415 )   Save BACKGROUND: Due to the application of immunosuppressants and broad-spectrum antibiotics after kidney transplantation, complicated infected pathogen emerges, illness becomes serious and death rate is high. Therefore, it is the key to improve infection cure rate by raising awareness of pathogenic characteristics of rare bacteria combined after kidney transplantation and early appropriate treatment. OBJECTIVE: To investigate the clinical characteristics and treatment of Penicillium marneffei infection after kidney transplantation. METHODS: Clinical data, predisposing factors, pathogenic characteristics and treatment of one kidney transplantation patient were analyzed retrospectively in June 2010.   RESULTS AND CONCLUSION: Clinical manifestations with chills, fever, oliguria, abdominal distension, cough, sputum, weight loss and fatigue were shown in the patient. Blood routine examination: white blood cells (1.42-2.51)×109/L, hemoglobin 66-83 g/L, platelets (21-43)×109/L, C-reactive protein 179.0-212.0 mg/L, procalcitonin-u 17.2-28.9 μg/L. The growth of Penicillium marneffei was shown in the chest, ascites and blood culture. But the symptoms were not improved after 250 mg/d intravenous infusion of itraconazole, suspension of immunosuppressants and immune support with gamma globulin and thymosin. Eventually, the patient gave up the treatment because of respiratory and circulatory failure. Clinical cases of Penicillium marneffei infection after kidney transplantation are rare, so the cinician have a little understanding of it. Thus, there is in demand for a consideration to the Penicillium marneffei infection for patients who have extremely low immune function with recurrent fever and multiple organ dysfunctions. Biphasic fungal culture and antigen determination if permitted need to be done for early diagnosis. Related Articles | Metrics