Management of vascular complications after kidney transplantation caused by donor derived infection: a report of 6 cases / 中华器官移植杂志

Objective:To summarize the institutional experiences of treating vascular complications caused by donor-derived infection(DDI)after kidney transplantation(KT).Methods:From January 1, 2015 to December 31, 2020, clinical data were retrospectively reviewed for 6 cases of vascular complications caused by DDI.Age, gender, surgical approaches, immunity induction therapy, immune suppression therapy, infection prevention, onset time of complication, type of complications, infection pathogens, therapeutic protocols and prognoses were summarized.Results:Six patients developed vascular complications caused by DDI in 997 KT recipients with an overall morbidity rate of 0.6%.In 3 cases, carbapenem resistant Klebsiella pneumoniae were positive in culture of secretion and blood samples.And Candida albicans was detected by blood cultures and pathological examinations.One case of antibiotic resistant Staphylococcus aureus was detected by blood culture.Among 3 cases of transplant kidney artery pseudoaneurysm on interventional therapy, there were curing(1 case)and immediate recurrent infection(2 cases). The latter two eventually died by cardiac complications.In 2 cases of arterial hemorrhage, graft nephrectomy was followed by hemodialysis.One case of transplanted renal artery stenosis was successfully cured by artery stenting and survived with normal graft function so far.Conclusions:Interventional endovascular therapy and open surgery are indicated for vascular complications caused by DDI post-KT.Interventional therapy may boost the odds of rescuing transplant kidney.However, clinicians should watch out for the risk of recurrent infection.Open surgery is an effective tool of eliminating infected focus.Preserving transplant kidney or nephrectomy may be adopted on the basis of specific conditions.

The report of two cases infection with novel coronavirus (2019-ncov) after kidney transplantation and the association literature analyzation / 中华器官移植杂志

Objective@#To investigate the clinical experience of patients with novel coronavirus (2019-ncov) infection after kidney transplantation.@*Method@#Clinical data of two patients with 2019-nCoV infection after renal transplantationin Jan 2020 Renmin Hospital of Wuhan Universiyt were retrospectively analyzed.Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months after transplantation. CT imaging showed multiple patchy ground-glass images of both lungs. Case 2 was a 59-year-old male, who was screened positive for 2019-nCoV nucleic acid due to fever at 9 days after renal transplantation and showed no clinical manifestations of pneumonia. After diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium + linezolid to resist infection, gamma globulin to enhance immunity function, methylprednisolone to control inflammatory response, antiviral regimens including arbidol tablets + lopina-velitonavir tablets. Case 2 was treated with isolated treatment in a single room. The treatment plan included anti-infection (cefoperazone sulbactam sodium), enhancing immunity function (gamma globulin), antivirus therapy with arbidol and other symptomatic treatment.@*Result@#Follow up with 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test with nasopharyngeal swabs turned negative, and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms, and the nucleic acid test of nasopharyngeal swabs turned negative for 3 times.@*Conclusion@#Renal transplant recipients should receive fine protection to avoid exposure to high-risk environments. Diagnosis should be defined with combination of clinical manifestations, nucleic acid test and pulmonary imaging. At present, there are no antiviral drugs and symptomatic treatment is the main choice.

Clinical characteristics of novel coronavirus pneumonia in organ transplant recipients and management strategy during the epidemic (1st edition) / 器官移植

In December 2019, a number of cases of pneumonia with unknown causes were successively reported in multiple hospitals in Wuhan City, Hubei Province, China. The pathogen is a novel coronavirus, which can lead to novel coronavirus pneumonia (COVID-19) and even threaten the patients' lives. In the following, the COVID-19 epidemic is spreading rapidly in many provinces and cities. It is particularly important to summarize and analyze the clinical characteristics of COVID-19 in solid organ transplantation (SOT) recipients and to optimize the prevention, early diagnosis and treatment strategies. Therefore, we organized Chinese experts in the field of organ transplantation to draft this article according to the characteristics of lung infection of SOT recipients and the characteristics of current COVID-19 by referring to relevant guidelines and specifications at home and abroad, aiming to provide reference for transplant physicians in China. This management strategy will be revised at any time with the deepening understanding of the COVID-19 infection.

Development and validation of radiomics model built by incorporating machine learning for identifying liver fibrosis and early-stage cirrhosis / 中华医学杂志(英文版)

BACKGROUND@#Liver fibrosis (LF) continues to develop and eventually progresses to cirrhosis. However, LF and early-stage cirrhosis (ESC) can be reversed in some cases, while advanced cirrhosis is almost impossible to cure. Advances in quantitative imaging techniques have made it possible to replace the gold standard biopsy method with non-invasive imaging, such as radiomics. Therefore, the purpose of this study is to develop a radiomics model to identify LF and ESC.@*METHODS@#Patients with LF (n = 108) and ESC (n = 116) were enrolled in this study. As a control, patients with healthy livers were involved in the study (n = 145). Diffusion-weighted imaging (DWI) data sets with three b-values (0, 400, and 800 s/mm) of enrolled cases were collected in this study. Then, radiomics features were extracted from manually delineated volumes of interest. Two modeling strategies were performed after univariate analysis and feature selection. Finally, an optimal model was determined by the receiver operating characteristic area under the curve (AUC).@*RESULTS@#The optimal models were built in plan 1. For model 1 in plan 1, the AUCs of the training and validation cohorts were 0.973 (95% confidence interval [CI] 0.946-1.000) and 0.948 (95% CI 0.903-0.993), respectively. For model 2 in plan 1, the AUCs of the training and validation cohorts were 0.944, 95% CI 0.905 to 0.983, and 0.968, 95% CI 0.940 to 0.996, respectively.@*CONCLUSIONS@#Radiomics analysis of DWI images allows for accurate identification of LF and ESC, and the non-invasive biomarkers extracted from the functional DWI images can serve as a better alternative to biopsy.

Two cases infected with novel coronavirus (2019-nCoV) after kidney transplantation and a review of related literature / 中华器官移植杂志

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.

Expression analysis of long non-coding RNAs in a renal ischemia-reperfusion injury model

Abstract Purpose: To investigate the long non-coding RNAs (lncRNAs) profile on renal ischemia reperfusion in a mouse model. Methods: Microarray analysis was used to study the expression of misregulated lncRNA in a mouse model of renal ischemia reperfusion(I/R) with long ischemia time. Quantitative real-time PCR (qPCR) was used to verify the expression of selected lncRNAs and mRNAs.The potential functions of the lncRNA was analyzed by bioinformatics tools and databases. Results: Kidney function was impaired in I/R group compared to the normal group. Analysis showed that a total of 2267 lncRNAs and 2341 messenger RNAs (mRNAs) were significantly expressed in I/R group (≥2.0-fold, p < 0.05).The qPCR result showed that lncRNAs and mRNAs expression were consistent with the microarray analysis. The co-expression network profile analysis based on five validated lncRNAs and 203 interacted mRNAs showed it existed a total of 208 nodes and 333 connections. The GO and KEEG pathway analysis results showed that multiple lncRNAs are involved the mechanism of I/R. Conclusion: Multiple lncRNAs are involved in the mechanism of I/R.These analysis results will help us to further understand the mechanism of I/R and promote the new methods targeted at lncRNA to improve I/R injury.

Diagnosis and treatment of BK virus-associated nephropathy after renal transplantation / 中华器官移植杂志

Objective@#To explore the diagnosis and treatment of BKV nephropathy after renal transplantation.@*Methods@#A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA. And 21 patients with positive results underwent graft biopsies for confirming a diagnosis.@*Results@#Among 21 cases of BKV infection, 20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus. One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF. Among 11 cases with urine (+ ) and blood (-), urinary BKV-DNA turned negative & creatinine decreased markedly (n=4), urinary BKV-DNA load decreased & creatinine stablized (n=4), death from pulmonary infection with hepatic & renal failure (n=1), urine BKV-DNA load decreased & creatine increased (n=1), BKV–DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine; Among 9 cases with urine (+ ) & blood (+ ), blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n=6), blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1); One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection.@*Conclusions@#BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity. However, clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents.

Diagnosis and treatment of BK virus-associated nephropathy after renal transplantation / 中华器官移植杂志

Objective To explore the diagnosis and treatment of BKV nephropathy after renal transplantation .Methods A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA . And 21 patients with positive results underwent graft biopsies for confirming a diagnosis .Results Among 21 cases of BKV infection ,20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus .One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF .Among 11 cases with urine (+ ) and blood (-) ,urinary BKV-DNA turned negative & creatinine decreased markedly (n= 4) ,urinary BKV-DNA load decreased & creatinine stablized (n= 4) ,death from pulmonary infection with hepatic & renal failure (n=1) ,urine BKV-DNA load decreased & creatine increased ( n = 1 ) , BKV – DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine ;Among 9 cases with urine (+ ) & blood (+ ) ,blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n= 6) ,blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1);One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection .Conclusions BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity . However ,clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents .

Clinical study of unplanned re-operation after renal transplantation / 中华器官移植杂志

Objective To analyze the reasons and outcomes of the unplanned re-operation in renal transplant recipients during perioperative period,and to summarize the corresponding strategies.Methods From January 2014 to September 2017,the clinical data of 20 cases of kidney transplantation which had a total of 22 unplanned re-operations were retrospectively analyzed.All patients were given quadruple immunosuppression with antibody induction and tacrolimus (TAC) and mycophenolate mofetil (MMF) plus prednisone (Pred).We analyzed the reasons,occurrence time,effect of re-operation and the renal function,as well as survival rate of all graft and recipient.The delayed graft function (DGF),acute rejection (AR) and incidence of pulmonary infection were monitored as well.Results Up to September 2017,during the follow-up of 1-36 months,the overall rate of unplanned re-operation was 4.6％,and 2 patients underwent 3 operations.For the reasons of re-operation,there were 18 cases of bleeding (13 cases of blood oozing from the wound surface,3 cases of renal parenchyma rupture because of rejection,and 2 cases of rupture of renal artery infection),2 cases of renal artery thrombosis and 2 cases of the repair of leakage of urine.Two operations were performed within 1 days for 9 cases,2-5 days for 5 cases,6-10 days for 3 cases,above 10 days for 45 cases.There was no deaths during the perioperative period.One patient died of rupture of exiliac aneurysm 3 months after the operation.One patient died of cerebral hemorrhage 6 months postoperation.The death censored graft survival rate was 72.2％ (13/18) and the incidence of DGF was 55 ％.Conclusion The major reason of unplanned re-operation for renal transplantation is associated with bleeding of various causes.And the incidence of DGF is high.If the secondary operation was performed with the correct decision,the kidney allograft recovers well.

Renal transplantation from rhabdomyolysis in three cases / 中华器官移植杂志

Objective To summarzie the experiences of kidney transplantation from rhabdomyolysis.Methods The surgical procedures and treatment protocols of the kidney transplantation in 3 cases from DD donors who suffered from anuria due to rhabdomyolysis were retrospectively analyzed.Results Three recipients were donated by two donors.When the blood of kidneys is washed out,the color of the kidneys was brown,and when the kidneys restored the blood perfusion,the transplanted kidneys were dark brown.All of these 3 cases had delayed renal function,and 2 recipients who received the kidneys from the same donor secreted the urine 3 weeks after surgery.The creatinine gradually decreased,and they discharged when the renal function was normal.The urine volume in the another recipient was 3000 ml or more per day in the first two days,gradually decreased from the third day,until anuria.We conducted an exploration of the transplanted kidney due to the area of transplantation uplift.We found that the kidney was bright red during the operation,the hematoma was removed and hemostasis was done,the urine volume gradually increased from one week after surgery,and the creatinine levels gradually decreased.After two months the creatinine levels were 103μmol/L.Conclusion For the patients with rhabdomyolysis,their kidneys can be transplanted after active preservation,evaluation of the donor kidney function and blood flow,and the short-term outcome is satisfactory.

Double-bundle versus single-bundle anterior cruciate ligament reconstruction with allogeneic tendon via single femoral tunnel / 中国组织工程研究

BACKGROUND: The anterior cruciate ligament (ACL) is an extremely important static structure that stabilizes the structure of the knee joint. Many scholars have found that an insufficient understanding of normal anatomical structure and biological characteristics of the ACL results in poor outcomes in the ACL reconstruction. OBJECTIVE: To compare the clinical effects of single-bundle and double-bundle single-tunnel techniques in ACL reconstruction with allogeneic tendon. METHODS: (1) Anatomy research: Six fresh knee joints were used for the experiments, and X-ray, CT and MRI were taken for each sample to confirm no osteoclasia, tumor and collapse of ACL. Then the ACL was stripped from the tibial bone and used to run hematoxylin-eosin staining and observe the fiber distribution of each piece of the ACL. (2) Clinical research: A total of 40 cases of ACL arthroscopic reconstruction were involved in this study, including 19 single-bundle ones and 21 double-bundle ones. The International Knee Documentation Committee 2000 subjective knee form (IKDC2000), Tegner and Lysholm evaluations were performed in all the patients. Paired t-test was used to analyze the IKDC, Tegner and Lysholm scores before operation and at follow-up time. RESULTS AND CONCLUSION: Anatomy research: From the view of anatomy, there was no evidence to support the double beams of the ACL at the tibial end by hematoxylin-eosin staining. Clinical research: Forty patients (40 knee joints) were successfully followed for over 12 months, and their joint range of motion was normal. The IKDC, Tegner and Lysholm scores were all improved in both two groups after the surgery, while the Larson scores were significantly higher in the double-bundle group than the single-bundle group. To conclude, the single-tunnel double-bundle ACL reconstruction is better to restore the knee stability than the single-bundle ACL reconstruction. This is an easy operation that has the merits of operating conveniently, restoring the normal anatomy of the tibial end, and exhibiting excellent short-term therapeutic effects. However, its long-term effects are uncertain.

The changes of venous blood before and after travel by high speed train / 中华普通外科杂志

Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.

Study on the Migration of Residual Styrene to Moxifloxacin Hydrochloride and Sodium Chloride Injection from Five-layer Co-extrusion Bags / 中国药师

Objective:To establish a monitoring method for the detection of styrene monomer migration to moxifloxacin hydrochlo-ride and sodium chloride injection. Methods:A GC-MS method with a DB-5MS (30 m×0.25 mm,0.25 μm) column was used to determine styrene by the manner of large volume headspace purge-trap. Results:The linearity of styrene was good within the range of 0.009 1-0.364 μg·ml-1(r=0.999 9),and the average recovery of styrene in moxifloxacin hydrochloride and sodium chloride injec-tion was 99.4%(RSD=1.1%,n=9). After the detection of several batches of samples,the amount of styrene migration was all be-low the detection limit.Conclusion:The method can be used to measure the migration of styrene remained in five-layer co-extrusion in-fusion bags to moxifloxacin hydrochloride and sodium chloride injection.

The changes of venous blood before and after travel by high speed train / 中华普通外科杂志

Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.

Effects of Kanglaite injection combined with gefitinib on inflammatory factors and immune function with advanced lung cancer / 中国生化药物杂志

Objective To study effects of Kanglaite injection combined with gefitinib on inflammatory factors and immune function in patients with advanced lung cancer.Methods 98 patients with advanced lung cancer in First People 's Hospital of Yuhang District from December 2013 to September 2016 were selected and randomly divided into gefitinib-treated group and combination drug-treated group with 49 cases in each group.The patients in the gefitinib-treated group were treated with gefitinib, the patients in the combination drug-treated group were treated with gefitinib and Kanglaite injection.The clinical efficacy, inflammatory factors, immune function, quality of life and adverse reactions were observed and compared between the two groups. Results The efficacy and control rate in combination drug-treated group were higher than gefitinib-treated group(P<0.05).The inflammatory factors such as CRP, IL-6 and TNF-αwere significantly improved in the two groups before treatment, and the combination drug-treated group improved significantly better than gefitinib-treated group(P<0.05).The levels of cellular immune factors in the two groups were significantly improved compared with that before treatment, and the combination drug-treated group was significantly better than the gefitinib-treated group(P<0.05).The quality of life in the combination drug-treated group was significantly higher than the gefitinib-treated group(P<0.05).The incidence of adverse reactions such as nausea and vomiting, thrombocytopenia, and renal dysfunction in combination drug-treated group was lower than in the gefitinib-treated group( P<0.05).Conclusion Application of gefitinib combined with Kanglaite injection in the treatment of patients with advanced lung cancer treatment is more significant, can effectively reduce the systemic inflammation and adverse reactions, improve immune function and quality of life.

Transcriptional activation of nuclear estrogen receptor and progesterone receptor and its regulation / 生理学报

Estrogen receptor (ER) and progesterone receptor (PR) are two important members of steroid receptors family, an evolutionarily conserved family of transcription factors. Upon binding to their ligands, ER and PR enter cell nucleus to interact with specific DNA element in the context of chromatin to initiate the transcription of diverse target genes, which largely depends on the timely recruitment of a wide range of cofactors. Moreover, the interactions between steroid hormones and their respective receptors also trigger post-translational modifications on these receptors to fine-tune their transcriptional activities. Besides the well-known phosphorylation modifications on tyrosine and serine/threonine residues, recent studies have identified several other covalent modifications, such as ubiquitylation and sumoylation. These post-translational modifications of steroid receptors affect its stability, subcellular localization, and/or cofactor recruitment; eventually influence the duration and extent of transcriptional activation. This review is to focus on the recent research progress on the transcriptional activation of nuclear ER and PR as well as their physiological functions in early pregnancy, which may help us to better understand related female reproductive diseases.

Effect of pretreatment with allopurinol on the expression of Bax,Bcl-2 and Caspase-3 in kidney of ischemia-reperfusion injury rats / 器官移植

Objective To investigate the effect and mechanism of pretreatment with allopurinol on renal ischemia-reperfusion injury (IRI)in rats.Methods Twenty four rats were randomly assigned into the sham operation (S), ischemia-reperfusion (IR)and allopurinol pretreatment (APC)groups (n =8 for each group).At preoperative 2 weeks, allopurinol at a dose of 50 mg/(kg·d)was administered via intraperitoneal injection in the APC group,and an equivalent quantity of physiological saline was given via intraperitoneal injection in the S and IR groups.After pretreatment,the right kidneys of rats in the S group were resected.In the IR and APC groups,the right kidneys were resected and the left kidneys were treated with 30 min ischemia-reperfusion.Blood sample was collected at 24 h after reperfusion and the kidney specimen was obtained at postoperative 2 weeks.The levels of blood urea nitrogen (BUN)and serum creatinine (Scr)were detected by automatic biochemistry analyzer.The activity of plasma malondialdehyde (MDA)and superoxide dismutase (SOD)was respectively assessed by detection kits.The expression levels of Bax,Bcl-2 and Caspase-3 of rat kidney were measured by western blot.Pathological changes in the rat kidney were observed under light microscope.Cell apoptosis of rat kidney was evaluated by TdT mediated-dUTP nick end labeling (TUNEL).Results Compared with the S group,the levels of BUN, Scr and plasma MDA in the IR and APC groups were significantly increased,whereas the activity of plasma SOD was significantly reduced (all in P <0.05).Compared with the IR group,the levels of BUN,Scr and plasma MDA in the APC group were significantly reduced,whereas the activity of plasma SOD was considerably elevated (all in P <0.05).Compared with the S group,the expression levels of Bax and Caspase-3 proteins were significantly up-regulated in the IR and APC groups,and the levels in the APC group were considerably lower than those in the IR group (all in P <0.05).Compared with the S group,the expression of Bcl-2 in rat kidney in the IR and APC groups was significantly down-regulated,and the value in the APC group was dramatically higher than that in the IR group (all in P <0.05).Under light microscope,the morphology of rat kidney was intact and normal in the S group.In the IR group,evident renal tubular ectasia,massive necrosis of renal tubular epithelial cells,evident stromal edema and a large quantity of lymph cellular infiltration were observed.In the APC group,mild renal tubular ectasia was observed,whereas no apparent kidney stromal edema was noted.A slight amount of lymph cellular infiltration was noted in the stroma.TUNEL staining revealed that the apoptosis rate of kidney cells in the S,IR and APC groups was (4.1 ±1 .7)%,(32.8 ±8.9)% and (1 2.6 ±3.4)% (all in P <0.05).Conclusions Allopurinol pretreatment could suppress cell apoptosis through anti-oxidation effect,thereby alleviating IRI of rat kidney and improving renal function.

Clinical Effect of Ganglioside Sodium in the adjuvant Treatment of Acute Cerebral Infarction and Influence on hs-CRP and TNF-αin serum / 中国药师

To explore the clinical effect of ganglioside sodium in the treatment of acute cerebral infarction and its influ-ence on hs-CRP and TNF-α in serum. Methods:A total of 216 patients with acute cerebral infarction were randomly divided into the observation group and the control group. The control group (108 cases) was given regular treatment, and the observation group (108 cases) was given 100 mg ganglioside in 250 ml 0. 9% sodium chloride, ivd, qd additionally, and the treatment course was 14d. The clinical effect of the two groups was compared, and the change of hs-CRP and TNF-αin serum was also researched in both groups. Re-sults:The total effective rate of the observation group was 90. 7%, which was obviously higher than that of the control group (71. 3%, P<0. 05). After the treatment, the NDS score of the observation group was lower than that before the treatment, while the ADL score was higher than that before the treatment (P<0. 05). After the treatment, the level of hs-CRP and TNF-α in serum was higher than that before the treatment in the two groups (P<0. 05), and that in the observation group was higher than that in the control group (P<0. 05). During the treatment, no adverse reaction was shown in the two groups. Conclusion:The clinical effect of ganglioside sodi-um in the treatment of acute cerebral infarction is promising, which can reduce the level of hs-CRP and TNF-αin serum of the patients and improve the scores of NDS and ADL with good safety, and is worthy of further clinical application.

Study on main pharmacodynamic effects for Schisandra lignans based upon network pharmacology / 中国中药杂志

In this study, we focused on the study of pharmacodynamic effects for 6 major bioactive lignans of Schisandra chinensis, namely deoxyschizandrin, schisandrin B, schisandrin C, schisandrin, schizandrol B and schisantherin A. A compound-gene-pathway network, which contained 124 related genes and 88 pathways, was constructed by collecting drug genes through mining relevant literatures and network pharmacology analysis. Based on the network analysis, 32 pathways and 80 related genes were associated with inflammation, which implied that anti-inflammatory might be the major pharmacodynamic effects of these compounds. All lignans except schizandrol B reduced LPS-induced NO production in RAW264.7 cells, which validated the anti-inflammatory hypothesis generated from network analysis. Furthermore, we investigated the effects of deoxyschizandrin, schisandrin C, schisandrin and schisantherin A on the secretion of inflammatory cytokines TNF-α, IL-1β, IL-6, PGE2 and protein expressions of iNOS, COX-2. As a result, deoxyschizandrin showed the strongest anti-inflammatory activity with inhibitory effect on all 4 inflammatory cytokines secretions and protein expressions of iNOS, COX-2. This study provided evidences for systematic exploration on the pharmacolgical actions and mechanisms of schisandra.

Comparative study of application of standard double-and single-dose of basiliximab in renal ;transplantation / 器官移植

Objective To compare clinical efficacy and safety between standard double-and single-dose of basiliximab in renal transplantation.Methods A total of 121 patients undergoing allogeneic cadaveric renal transplantation in Department of Urology of Renmin Hopsital of Wuhan University from January 2008 to May 2011 were recruited as study subjects.Among them,53 patients were assigned into the double-dose of basiliximab group and they were intravenously administered with 20 mg of basiliximab before and 4 d after surgery according to product description.Sixty-eight cases were allocated in the single-dose of basiliximab group and they were given with 20 mg of basiliximab before renal transplantation.The changes of immune function in two groups during perioperative period were monitored.The incidence of adverse reactions including delayed graft function (DGF),acute rejection,pulmonary infection and the survival of patients and renal grafts were statistically compared between two groups.Results There was no significant difference in preoperative humoral immune and cellular immune function between two groups.Compared with preoperative period,cellular and humoral immune function in both groups were inhibited by varying degree at 5 d after surgery (both in P <0.05).Compared with patients in the single-dose group,cellular and humoral immune functions were evidently suppressed in the double-dose group (both in P <0.05).Compared with the parameters assessed at 5 d after surgery,cellular and humoral immune functions were restored to varying degree at 15 d after surgery,whereas still significantly lower than preoperative levels (CD3,CD4,IgM and IgA).Partial parameters (CD8 and IgG)were persistently inhibited and continued to decline compared with the levels at 5 d after surgery.The incidence of DGF was 8% in the double-dose group,and 7% in the single-dose group.During 1-year follow-up,the rejection rates in the double-and single-dose groups were 13% and 12%,and the incidence of pulmonary infection was 9% and 10%.No statistical significance was noted between two groups in terms of these parameters (all in P >0.05).The 1-year survival of patients in the double-and single-dose groups was 94% and 98%,93% and 96% for the survival of renal grafts.No statistical significance was found between two groups (both in P >0.05).Conclusions Both double-and single-dose of basiliximab are efficacious in renal transplantation and do not increase the incidence of adverse reaction.The 1-year survival rates of patients and renal grafts between two groups are almost equivalent.Detection of immune function during perioperative period effectively guides individualized immune induction therapy.