Implementation Strategy Analysis of Clinical Pathway in Large Public Hospitals under DRG Payment Reform / 中国医院管理

Clinical pathway has great similarity with DRG,and plays an important role in standardizing diagnosis and treatment behavior and controlling medical expenses.Based on the analysis of the relationship between DRG payment method reform and clinical pathway,taking a public hospital in Wuhan City,Hubei Province as an example,the clinical pathway implementation strategy of large public hospitals under the DRG payment method reform was explored from five aspects:management system,suitable disease types,doctor's order setting,information system,training and assessment.

Construction and application of an information platform for performance appraisal of tertiary public hospitals based on real-time supervision / 中华医院管理杂志

It is of great significance to construct an information platform for performance appraisal of tertiary public hospitals to realize real-time monitoring and intervention of appraisal indicators, which is conducive to the transmission of responsibility for index optimization to departments and medical groups, and to promote the fine management of hospitals and promote high-quality development.This paper introduced the practice and effect of building a performance appraisal information platform for tertiary public hospitals in four aspects: accurate data filling, timely dynamic monitoring, visual display and safety management since 2022. At the same time, suggestions were put forward for platform optimization from four aspects: data quality control, co-construction and sharing, promotion and application, and system integration, in order to provide reference for other hospitals.

Characteristics and management approaches of patients admitted to isolation ward in public general hospitals under regular epidemic prevention and control of coronavirus disease 2019 / 中华传染病杂志

Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Mental health, health-related quality of life, and lung function after hospital discharge in healthcare workers with severe COVID-19: a cohort study from China / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is highly contagious and can cause death in severe cases. As reported by the World Health Organization (WHO), as of 6:36 pm Central European Summer Time (CEST), 12 August 2022, there had been 585 950 285 confirmed cases of COVID-19, including 6 425 422 deaths (WHO, 2022).

International innovative health technology payment strategy and enlightenment under diagnosis-related groups payment system / 中华医院管理杂志

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

Multi-organ Proteomic Landscape of COVID-19 Autopsies

The molecular pathology of multi-organ injuries in COVID-19 patients remains unclear, preventing effective therapeutics development. Here, we report an in-depth multi-organ proteomic landscape of COVID-19 patient autopsy samples. By integrative analysis of proteomes of seven organs, namely lung, spleen, liver, heart, kidney, thyroid and testis, we characterized 11,394 proteins, in which 5336 were perturbed in COVID-19 patients compared to controls. Our data showed that CTSL, rather than ACE2, was significantly upregulated in the lung from COVID-19 patients. Dysregulation of protein translation, glucose metabolism, fatty acid metabolism was detected in multiple organs. Our data suggested upon SARS-CoV-2 infection, hyperinflammation might be triggered which in turn induces damage of gas exchange barrier in the lung, leading to hypoxia, angiogenesis, coagulation and fibrosis in the lung, kidney, spleen, liver, heart and thyroid. Evidence for testicular injuries included reduced Leydig cells, suppressed cholesterol biosynthesis and sperm mobility. In summary, this study depicts the multi-organ proteomic landscape of COVID-19 autopsies, and uncovered dysregulated proteins and biological processes, offering novel therapeutic clues. HIGHLIGHTSO_LICharacterization of 5336 regulated proteins out of 11,394 quantified proteins in the lung, spleen, liver, kidney, heart, thyroid and testis autopsies from 19 patients died from COVID-19. C_LIO_LICTSL, rather than ACE2, was significantly upregulated in the lung from COVID-19 patients. C_LIO_LIEvidence for suppression of glucose metabolism in the spleen, liver and kidney; suppression of fatty acid metabolism in the kidney; enhanced fatty acid metabolism in the lung, spleen, liver, heart and thyroid from COVID-19 patients; enhanced protein translation initiation in the lung, liver, renal medulla and thyroid. C_LIO_LITentative model for multi-organ injuries in patients died from COVID-19: SARS-CoV-2 infection triggers hyperinflammatory which in turn induces damage of gas exchange barrier in the lung, leading to hypoxia, angiogenesis, coagulation and fibrosis in the lung, kidney, spleen, liver, heart, kidney and thyroid. C_LIO_LITesticular injuries in COVID-19 patients included reduced Leydig cells, suppressed cholesterol biosynthesis and sperm mobility. C_LI

Strategies for emergency cardiovascular surgery under the epidemic of COVID-19 / 中华胸心血管外科杂志

Severe acute respiratory infection caused by a novel coronavirus(SARS-CoV-2), WHO named COVID-19, is the major clinical concern globally. Both the world health organization and the National Health Commission have issued interim guidelines and management strategy for the diagnosis and treatment of COVID-19. These comprehensive guidelines establish the basic norms for the clinical practice. However, cardiovascular diseases have their special pathophysiological characteristics. The surgical treatment strategies for emergency and critical cardiovascular diseases requires specific recommendations or guidelines. From 16 January to 12 February 2020, the department of cardiovascular surgery in Wuhan Union Hospital had performed 15 emergency cardiovascular operations. The perioperative success rate is 100%. Based on our clinical practice, we summarized the relevant experience as a complement to the WHO and National Health Commission guidelines, hope to provide references for the cardiovascular surgeons.

Suggestions and summaries on multi-center management of acute aortic dissection surgery during COVID-19 epidemic in Hubei province / 中华胸心血管外科杂志

Objective:Since December 2019, novel coronavirus infection has occurred in Hubei province and spread throughout the country quickly. This new crown viral pneumonia was named as coronavirus disease of 2019 (COVID-19) by WHO. However, at present, there is a high incidence of acute aortic dissection in winter and spring. How to prevent the spread of the epidemic and choose the appropriate treatment is an important topic for the patients with acute aortic dissection.Methods:From January 16, 2020 to February 26, 2020, a total of 37 of acute aortic dissection operations were carried out in several cardiovascular surgery centers in Hubei Province. There were 18 cases of Stanford type A aortic dissection and 19 cases of Stanford type B aortic dissection. There were 10 cases (55.55%) with ascending aorta replacement and 7 cases (38.89%) with Bentall procedure for aortic root surgery, and total arch replacement with stented elephant trunk implantation were performed in 14 cases (77.8%). In 19 patients with Stanford type B aortic dissection, thoracic endovascular aortic repair was performed, with the left subclavian artery chimney technique in 2 cases.Results:No deaths occurred within 30 days of hospitalization. Preoperative nucleic acid testing excluded 7 cases of novel coronavirus infection, and 3 suspected cases underwent emergency surgery. the three-level protective standard was adopted in the majority of the surgeries(62.2%, 23/37), and 11 patients were negative in the reexamination of viral nucleic acid after the operation.Conclusion:During the epidemic period, patients with acute aortic dissection should be carefully identified with actife COVID-19 before surgery. The treatment principles-" prevention and control of pneumonia epidemic should be emphasized, conservative medical management should be taken in the comfirmed cases, the selective operation should be delayed as far as possible, and the operation should be reasonable performed in critical cases" should be followed, which can save patients' lives to the greatest extent and prevent the spread of the virus.

Difficulties and strategies of public hospitals from the epicenter in their participation in the prevention and control of COVID-19 / 中华医院管理杂志

Outbreak of COVID-19 across the country has seriously threatened people′s lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save these patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authors described the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.

Difficulties and strategies of public hospitals in their participation in the prevention and control of novel coronavirus pneumonia / 中华医院管理杂志

Outbreak of the novel coronavirus pneumonia (NC) across the country has seriously threatened people's lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save the NCP patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authorsDescribed the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.

Surgical treatment of secondary endocardial fibroelastosis / 中华胸心血管外科杂志

Objective To investigate surgical treatment and effect of secondary endocardial fibroelastosis,based on respective analysis of clinical data and follow-up data of patients with secondary endocardial fibroelastosis (SEF) between 2010 and 2012.Methods A retrospective analysis was performed including 10 patients with secondary endocardial fibroelastosis from January 2010 to December 2012 in Wuhan Union Hospital.All patients were diagnosed by Untrasonic Cardiogram and/or CT angiography of heart and great vessel,and had cardiac insufficiency in different degree [EF 0.37 ± 0.08 (0.26 ～ 0.48)].All patients except 2 patients with anomalous origin of the coronary artery received treatment of digitaloid drugs before operation,which promoted preoperative cardiac function.5 patients with SEF complicated with Congenital Coarctation of the Aorta (CoA),2 patients underwent correction of CoA,2 patients underwent correction of CoA and partial resection of endocardium,1 patient underwent correction of CoA,partial resection of endocardium and mitral vavuloplasty.2 patients with SEF complicated with anomalous origin of the left coronary artery from the pulmonary artery,who were underwent correction of anomalous origin of coronary artery.2 patients with SEF complicated with aortic stenosis,who were underwent aortic commissurotomy and partial resection of endocardium.1 patient with SEF complicated with mitral stenosis and insufficiency,who underwent mitral valve replacement.The intraopertive gross appearance of endocardium was opaque greyish-white not transparent pink.The postoperative pathological examination showed obviously positive dyeing of elastic fibers.In 3,6,12 and 24 months after operation,Untrasonic Cardiogram evaluated cardiac function and endocardium.Results one 6 months patients with origin of left coronary from pulmonary artery died of severe post-operative low cardiac output syndrome,while another 1 months patients with origin of left coronary from pulmonary artery obtained post-operative good recovery,and the Untrasonic Cardiogram show disappearance of endocardial fibroelastosis.The post-operative mean time of using respirator(4.0 ± 1.5) days (2-7 days).Compared with the preoperative data,the cardiac function index (EF) was not significantly better at 2 weeks and 3-6 months[0.38 ± 0.07 (0.28 ～ 0.48),P ＞ 0.05 ; 0.39 ± 0.08 (0.30 ～ 0.50),P ＞ 0.05],and the non-resected fibroelatic endocardium still existed and were not attenuated.But the cardiac function index (EF) significantly increased [0.44 ± 0.08 (0.38 ～ 0.55),P ＜ 0.05] than the pre-operative EF,and the 3 of 5 cases the fibroelatic endocardium were attenuated or disappeared,while 2 of 5 cases the fibroelatic endocardium still existed.Conclusion SEF is the important causes of the infant intractable heart failure,which has the characteristic of high mortality and limited therapy.For SEF patients with anomalous origin of the coronary artery,the SEF is completely reversed by early diagnosis and early correction of the malformation.For SEF patients with CoA or aortic stenosis,the surgical treatment could promote recovery of cardiac function,but whether the SEF were reversed is still subject to further follow-up.The heart transplantation is the best therapy for SEF with severse heart failure.

Effects of acetylcholine on electrical remodeling of human atrial fibers / 华中科技大学学报（医学）（英德文版）

Autonomic nervous system activation can result in significant changes of atrial electrophysiology and facilitate induction of atrial fibrillation. By recording influence of different concentrations of acetylcholine (ACh) on atrial fibers (AF), we investigated the role of the increased vagal tone in electrical remodeling in atrial fibrillation. Parameters of action potentials and force contraction (Fc) in atrial fibers were recorded by using standard intracellular microelectrode technique and force transducer. It was found that: (1) ACh at 0.1 μmol/L had no significant influence on spontaneous action potentials (SAPs) and Fc (n=6, P>0.05); ACh at both 1.0 and 10.0 μmol/L shortened action potential duration (APD) and Fc of human AF from right atrium (n=6, P0.05), but ACh at 1.0 and 10.0 μmol/L had desensitization (n=6, P<0.05) to SAPs and Fc. The desensitization of ACh on APD in AF was concentration- and time-dependent. It was shown that APD was longer than the control along with extending time of continuous Tyrode's solution perfusion after desensitization. It is concluded that ACh changes the electrophysiological characteristics of human AF, indicating that increased vagal tone plays a role in the development of a vulnerable substrate for atrial electrical remodeling in atrial fibrillation.

Combined treatment with chemokine receptor 5 blocker and cyclosporine induces prolonged graft survival in a mouse model of cardiac transplantation.

BACKGROUND: Inhibition of chemokine receptor 5 (CCR5), a chemokine receptor expressed on activated T cells, is efficacious in modulating inflammation and immunity as well as in patients with human immunodeficiency virus infection. This study examined the effect and mechanism of CCR5 blockade in combination with cyclosporine in prolonging cardiac allograft survival in mice. METHODS: Hearts from BALB/c mice were transplanted into C57BL/10 recipients. They were administrated with anti-CCR5 antibody (Ab) or control Ab and cyclosporine or phosphate-buffered (PBS) saline, respectively. To investigate the role of regulatory cells, naïve mice (secondary recipients) underwent adoptive transfer of splenocytes from anti-CCR5 Ab plus cyclosporine-treated recipients and cardiac allograft transplantation. RESULTS: Compared with recipients treated with control Ab plus PBS, allografts treated with anti-CCR5 Ab and cyclosporine showed significantly prolonged survival (p < 0.001), markedly decreased CD4+ and CD8+ T cells (p < 0.005), and increased frequency of CD4+CD25+Foxp3+ regulatory cells (23.98% +/- 1.55% vs 6.30% +/- 0.57%, p < 0.005). Adoptive transfer of CD4+CD25+ splenocytes from anti-CCR5 Ab plus cyclosporine-treated recipients induced significantly prolonged survival in secondary recipients (p < 0.01 vs adoptive transfer from naïve mice and recipients depleted of CD25+ cells). CONCLUSIONS: CCR5 blockade combined with cyclosporine is effective in protecting the cardiac allograft in a robust murine model. This effect is partly mediated by regulatory cell recruitment and control of effector cell infiltration.

Analysis of medical scientific theses of Union Hospital of Tongji Medical College in last 5 years / 中华医学科研管理杂志

The publication of the scientific theses and their management are significant for the development of technology and science in the hospital.Therefore.they play an important role iU the hospital management.The retrospective analysis on the theses that published in the last 5 years and embodied by SCI was conducted using the statistics method and analyzed the first 10 departments in the published theses in this paper.The specialty of our hospital and the shortcoming in the scientific research was concluded from the analysis result.The amount of the theses increased steadily,and the research capability of the key subjects and key departments were promoted.The amount and the quality of the theses reflected an important indicator of the development strategy that means to develop the hospital through science.technology and education.Therefore,these conclusions could offer some valuable information to the manage department of t}le hospital.

Effects of Metallothionein on Isolated Rat Heart / 华中科技大学学报（医学）（英德文版）

To investigate the effects of metallothionein (MT) on isolated rat heart, 16 Wistar rats were randomly divided into 2 groups. In control group (group C), distilled water was injected intraperitoneally and 24 h later isolated hearts were perfused with Langendorff and stored at 4℃ for 3 h with histidine-tryptophan-ketoglutarate (HTK) solutions, and then isolated hearts were perfused for 2 h by Langendorff. In experimental group (group E), 3.6% ZnSO4 was injected intraperitoneally, 24 h later isolated hearts were perfused by Langendorff and stored at 4℃ for 3 h with HTK solutions, and then the isolated herts were perfused for 2 h with Langendorff. MT content, the recovery of hemodynamics, myocardial water content (MWC), lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, adenosine triphosphate (ATP) and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, myocardial cell Ca2+ content, Ca2+-ATPase activity of mitochondria ([Ca2+-ATPase]m) and its Ca2+ content ([Ca2+]m), synthesizing ATP activity of mitochondria ([ATP]m), and the ultrastructure of cells were examined. There were a significant increase in group E in hemodynamic recovery, ATP content, SOD activity, [Ca2+-ATPase]m activity, [ATP]m activity, and substantial reduction in MWC, LDH and CK leakage, MDA content, myocardial cell Ca2+ content, [Ca2+]m content,and the ultrastructural injury were obviously milder than that of group C. This study demonstrated that MT has protective effects on isolated rat heart.

Influence of oxidized low density lipoprotein on the proliferation of human artery smooth muscle cells in vitro / 华中科技大学学报（医学）（英德文版）

The effects of oxidized low density lipoprotein (ox-LDL) on the proliferation of cultured human vascular smooth muscle cells (vSMC) were investigated in vitro. By using NaBr density gradient centrifugation, LDL was isolated and purified from human plasma. Ox-LDL was produced from LDL by being incubated with CuSO(4). ox-LDL was then added to the culture medium at different concentrations (35, 60, 85, 110, 135 and 160 microg/mL) for 7 days. The influence of ox-LDL on vSMC proliferation was observed in growth curve, mitosis index, and in situ determination of apoptosis. The data were analyzed with SPSS 10.0 software. The results showed that the ox-LDL produced in vitro had a good purity and optimal oxidative degree, which was similar to the intrinsic ox-LDL in atherosclerotic plaque. ox-LDL at a concentration of 35 microg/mL demonstrated the strongest proliferation inducement, and at a concentration of 135 microg/mL, ox-LDL could inhibit the growth of vSMC. ox-LDL at concentrations of 35 and 50 microg/mL presented powerful mitotic trigger, and with the increase of ox-LDL concentration, the mitotic index of vSMC was decreased gradually. ox-LDL at higher concentrations promoted more apoptotic vSMCs. ox-LDL at lower concentrations triggered proliferation of vSMCs, and at higher concentrations induced apoptosis in vSMCs. ox-LDL played a promotional role in the pathogenesis and development of atherosclerosis by affecting vSMC proliferation and apoptosis.

Influence of Oxidized Low Density Lipoprotein on the Proliferation of Human Artery Smooth Muscle Cells in vitro / 华中科技大学学报（医学）（英德文版）

The effects of oxidized low density lipoprotein (ox-LDL) on the proliferation of culturedhuman vascular smooth muscle cells (vSMC) were investigated in vitro. By using NaBr density gradient centrifugation, LDL was isolated and purified from human plasma. Ox-LDL was produced from LDL by being incubated with CuSO4. ox-LDL was then added to the culture medium at different concentrations (35, 60, 85, 110, 135 and 160 μg/mL) for 7 days. The influence of ox-LDL on vSMC proliferation was observed in growth curve, mitosis index, and in situ determination of apoptosis. The data were analyzed with SPSS 10.0 software. The results showed that the ox-LDL produced in vitro had a good purity and optimal oxidative degree, which was similar to the intrinsic ox-LDL in atherosclerotic plaque. ox-LDL at a concentration of 35 μg/mL demonstrated the strongest proliferation inducement, and at a concentration of 135 μg/mL, ox-LDL could inhibit the growth of vSMC. ox-LDL at concentrations of 35 and 50 μg/mL presented powerful mitotic trigger, and with the increase of ox-LDL concentration, the mitotic index of vSMC was decreased gradually. ox-LDL at higher concentrations promoted more apoptotic vSMCs. ox-LDL at lower concentrations triggered proliferation of vSMCs, and at higher concentrations induced apoptosis in vSMCs. ox-LDL played a promotional role in the pathogenesis and development of atherosclerosis by affecting vSMC proliferation and apoptosis.

Effects of metallothionein on isolated rat heart / 华中科技大学学报（医学）（英德文版）

To investigate the effects of metallothionein (MT) on isolated rat heart, 16 Wistar rats were randomly divided into 2 groups. In control group (group C), distilled water was injected intraperitoneally and 24 h later isolated hearts were perfused with Langendorff and stored at 4 degrees C for 3 h with histidine-tryptophan-ketoglutarate (HTK) solutions, and then isolated hearts were perfused for 2 h by Langendorff. In experimental group (group E), 3.6% ZnSO(4) was injected intraperitoneally, 24 h later isolated hearts were perfused by Langendorff and stored at 4 degrees C for 3 h with HTK solutions, and then the isolated hearts were perfused for 2 h with Langendorff. MT content, the recovery of hemodynamics, myocardial water content (MWC), lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, adenosine triphosphate (ATP) and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, myocardial cell Ca(2+) content, Ca(2+)-ATPase activity of mitochondria ([Ca(2+)-ATPase](m)) and its Ca(2+) content ([Ca(2+)](m)), synthesizing ATP activity of mitochondria ([ATP](m)), and the ultrastructure of cells were examined. There were a significant increase in group E in hemodynamic recovery, ATP content, SOD activity, [Ca(2+)-ATPase](m) activity, [ATP](m) activity, and substantial reduction in MWC, LDH and CK leakage, MDA content, myocardial cell Ca(2+) content, [Ca(2+)](m) content, and the ultrastructural injury were obviously milder than that of group C. This study demonstrated that MT has protective effects on isolated rat heart.

Expression of Cytokines in Acute Heart Transplantation Rejection / 华中科技大学学报（医学）（英德文版）

The expression and changes of local cytokines network were detected in heart transplantation in rats, so as to determine the role of cytokines in the acute rejection of rats of heart transplantation. Allografts were divided into 4 groups (n=12 in each group): group A (control), group B (IL-2 monoclonal antibody-treated), group C (CsA-treated) and group D (IL-2 monoclonal antibody+CsA-treated). Hearts from DA rats were transplanted into a cervical location in Wistar recipients. The local expression of IL-1β, IL-2, CD25, IL-4, IL-5, IL-6, IL-10, TNFα and INFγ was detected at day 1, 3, 5, 7, 9, 11 and 14 by reverse transcription polymerase chain reaction. The results showed that the survival time of allografts was 8.3±1.7, 29.2±7.1 (P＜0.05), 26.4±5.7 (P＜0.05) and 55.0±10.6 (P＜0.01) days respectively in groups A, B, C and D. The expression of IL-1β, IL-4, IL-10and IFNγ was up-regulated, and that of IL-2, CD25, IL-5, IL-6 and TNFα was significantly inhibited in group A; The expression of IL-1β, IL-5, IL-6, IL-10 and IFNγ was up-regulated, and that of IL-2,IL-4 and TNFα was significantly down-regulated in group B; The expression of IL-1β, IL-2, CD25,IL-5, TNFα and IFNγ was up-regulated, and that of IL-4, IL-6 and IL-10 was significantly down-regulated in group C; The expression of IL-14, Il-5, IL-6 and Il-10 was up-regulated, and that of IL-1β, IL-2, CD25, TNFα and IFNγ was significantly down-regulated in group D. In conclusion,cytokines play an important role in the development of acute transplantation rejection. Different cytokines play different roles in different local environments.