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Objective:To investigate the effect of Zhitong-Rusheng Decoction on wound healing and serum fibronectin (FN) and epidermal growth factor (EGF) levels after anal fistula operation. Methods:A total of 102 patients after anal fistula operation in our hospital from March 2018 to March 2020 were randomly divided into control group (51 cases) and observation group (51 cases) according to the random number table method. The control group was treated with conventional western treatment, while the observation group was treated with Zhitong-Rusheng Decoction on the basis of control group. The two groups were treated for 3 weeks. The clinical symptoms were scored before and after treatment, and the levels of serum FN and EGF were detected by ELISA. The wound healing time, hematochezia disappearance time, wound longitudinal diameter and wound area before and after treatment were observed. The clinical efficacy was evaluated after treatment. Results:The total effective rate was 98.0% (50/51) in the observation group and 72.6% (37/51) in the control group, with significant difference between the two groups ( χ2=13.209, P<0.01). After treatment, the pain degree score, wound exudation score and granulation morphology score of the observation group were significantly lower than those in the control group ( t=15.448, 21.424, 28.641, P<0.001). After treatment, the wound healing time [(6. 04 ± 1.20) d vs. (9.42 ± 1.58) d, t=12.166] and the disappearance time of hematochezia [(15.72 ± 2.86) d vs. (19.95 ± 4.33) d, t=6.862] of the observation group were significantly shorter than thosse of the control group( P<0.01). After treatment, the wound longitudinal diameter [(1.89 ± 0.31) cm vs. (2.82 ± 0.54) cm, t=10.666] and wound area [(3.26 ± 0.54) cm 2vs. (4.98 ± 1.10) cm 2, t=10. 024] of the observation group were significantly less than those in the control group ( P<0.01). The serum FN [(2.92 ± 0.50) mg/L vs. (2.45 ± 0.39) mg/L, t=5.293], EGF [(7.03 ± 1.44) μg/L vs. (5.47 ± 1.03) μg/L, t=6.293] of the observation group were significantly higher than those in the control group ( P<0.01). Conclusion:Zhitong-Rusheng Decoction on the basis of conventional treatment on patients after anal fistula operation has a good efficacy, which is conducive to wound healing, reducing clinical symptoms, and improving serum levels of FN and EGF.
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Metabolic disorders are observed in women after menopause, and the postmenopausal women suffering from chronic liver diseases have an increased risk of progression to liver fibrosis, with a higher risk than male patients of the same age, which may be associated with the decline of ovarian function and the reduction of estrogen level after menopause. This article summarizes the research advances in the molecular mechanism of progression to liver fibrosis from the aspects of estrogen and oxidative stress, activation of hepatic stellate cells, accumulation of extracellular matrix, and immune regulation. It is pointed out supplementation with an appropriate amount of estrogen in the perimenopausal period and the early menopausal period can reduce the risk of liver fibrosis and delay or even reverse the process of liver fibrosis, thereby improving quality of life and prolonging survival time in elderly female patients.
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Metabolic disorders are observed in women after menopause, and the postmenopausal women suffering from chronic liver diseases have an increased risk of progression to liver fibrosis, with a higher risk than male patients of the same age, which may be associated with the decline of ovarian function and the reduction of estrogen level after menopause. This article summarizes the research advances in the molecular mechanism of progression to liver fibrosis from the aspects of estrogen and oxidative stress, activation of hepatic stellate cells, accumulation of extracellular matrix, and immune regulation. It is pointed out supplementation with an appropriate amount of estrogen in the perimenopausal period and the early menopausal period can reduce the risk of liver fibrosis and delay or even reverse the process of liver fibrosis, thereby improving quality of life and prolonging survival time in elderly female patients.
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Objective:To explore the clinical significance of fetal ultrasound soft index positive in middle pregnancy.Methods:The clinical data of 486 pregnant women who were examined by prenatal ultrasound from February 2019 to November 2019 in the People's Hospital of Lujiang County were collected, and a retrospective analysis was made in 244 single positive indicator in 209 pregnant women who were positive by prenatal ultrasound.Results:Among 486 pregnant women, 209 cases were positive, with a positive rate of 43.0%(486/209). Among 244 positive items, 10 items were fetal malformation or defect, accounting for 4.10%; 106 items were fetal appendage, accounting for 43.44%; 128 items were fetal soft index, accounting for 52.46%.Conclusion:The soft index of ultrasound is the majority of the positive results in prenatal ultrasound examination.It is not suitable to over interpret the soft index of ultrasound to predict the risk of fetal chromosome, so as to prevent the panic of pregnant women and their families.The invasive prenatal diagnosis technology is chosen to cause over examination, and even to terminate pregnancy manually in some basic medical institutions, which will bring unnecessary harm to the mother and fetus.
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Objective:To explore the innovative measures of scientific and technological achievements transformation in hospital by taking the practical experience of scientific and technological achievements transformation of West China Hospital of Sichuan University (WCH).Methods:The data of patents and technological achievements transformation of WCH was analyzed.Results:WCH applied for 1 800 patents and granted 1 145 during January 2015 and December 2019. By 2019, the conversion rate of scientific and technological achievements of WCH reached 14%.Conclusions:WCH has achieved remarkable results in promoting the scientific and technological achievements transformation through a series of innovative explorations and practices, including building professional technology transfer organizations and teams, establishing achievement transformation incentive policies, developing technology transformation standard process and regulations, creating a positive atmosphere of achievement transformation , as well as actively cultivating high-value patents.
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Objective To explore the effects of residual renal function (RRF) on quality of life (QOL) in patients with continuous ambulatory peritoneal dialysis (CAPD),and analyze the factors influencing QOL.Methods One hundred and eighteen patients treated with CAPD for at least 3 months in No.455 Hospital of People's Liberation Army were enrolled.All patients were divided into two groups according to residual glomerular filtration rate (rGFR):the group with RRF [rGFR≥ 1 ml·min-1 · (1.73 m2)-1],and the group without RRF [rGFR ＜ 1ml · min-1 · (1.73 m2)-1].The demographic characteristics,laboratory data,cardiothoracic ratio,dialysis adequacy parameters,rGFR,blood pressure,urine volume,ultrafiltration volume and dialysis prescription were investigated.Patient's QOL was evaluated by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Results There was no significant differences between the groups with and without RRF in the age,gender,causes of disease,complication,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),haemoglobin (Hb),cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,normalized protein catabolic rate (nPCR) and cardiothoracic ratio (all P ＞ 0.05).Compared with the patients with RRF,PD duration,ultrafiltration volume,serum creatinine (Scr),calcium,phosphorus,C-reactive protein (CRP),parathyroid hormone (PTH) and peritoneal dialysis dose in the patients without RRF were significantly higher,and urine volume,serum albumin (Alb),potassium,and urea total Kt/V were significantly lower (all P ＜ 0.05).The patients without RRF had a significantly lower score in physical function and physical component summary as compared to the patients with RRF (all P ＜ 0.05).There was no significant differences in role physical,bodily pain,general health,vitality,social function,role emotional,mental health,mental component summary and SF-36 scores (all P ＞ 0.05).Simple linear regression showed that there was no correlation between rGFR and SF-36 scores (β=1.330,P=0.070).Multiple linear regression revealed that SF-36 scores were correlated with CRP (β=-0.477,P ＜ 0.001),Scr (β=0.020,P ＜ 0.001),cardiothoracic ratio (β=-57.823,P=0.004),Alb (β=0.772,P=0.016) and ultrafiltration volume (β=-0.006,P=0.031),but not correlated with rGFR (β=0.099,P=0.302).Conclusions PD patients without and with RRF perceived different scores in physical health,but their scores were similar in mental health and QOL.RRF was no related to QOL in PD patients.Chronic inflammation,fluid overload and malnutrition were the main factors that affect QOL.
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Objective: To investigate the effect of endocannabinoid system on cardiac hypertrophy in experimental rats with chronic intermittent hypoxia and to study the impact of endocannabinoid antagonist, rimonabant in such pathological processing. Methods: A total of 48 male Wistar rats were divided into 6 groups. 4 and 6 weeks of Normal control group, 4 and 6 weeks of Hypoxia group, 4 and 6 weeks of Hypoxia with rimonabant intervention group. n=8 in each group. The rats were sacrificed to measure left ventricular mass index (LVMI), the myocardial cell morphological changes were observed by optical microscope, the expression of cardiac calcium/calmodulin-dependent protein kinase II (CaMKII) and cardiotrophin-1 (CT-1) were detected by immunohistochemistry at 4 and 6 weeks respectively. Results: Compared with 4 and 6 weeks of Normal control group, the LVMI, cardiac hypertrophy condition, CaMKII and CT-1 were increased in 4 and 6 weeks of Hypoxia group, all P Conclusion: The Chronic intermittent hypoxia could induce myocardial hypertrophy via endocannabinoid system disorders, such pathological processing could be reduced by rimonabant intervention.
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BACKGROUND:The validity of stem celltransplantation for acute kidney injury has been verified by many studies. However, the mechanism of repair of tubular epithelial cellinjury remains unclear. OBJECTIVE:To investigate protective effects and mechanisms of adipose-derived stem cells cultured with astragaloside on the apoptosis of renal tubular epithelial cells induced by cisplatin. METHODS:There were four groups. Renal tubular epithelial cells were induced by 2.5μmol/L cisplatin for 24 hours. Models of renal tubular cellinjury were established in the cisplatin group. Adipose-derived stem cells were cocultured with renal tubular epithelial cells of injured kidney in the adipose-derived stem cells+renal tubular epithelial cells group. Using Transwel chamber, adipose-derived stem cells were incubated with 20 mg/L astragaloside for 48 hours, and then cocultured with renal tubular epithelial cells in the astragaloside-incubated adipose-derived stem cells+renal tubular epithelial cells group. Normal renal tubular epithelial cells served as controls (normal control group). RESULTS AND CONCLUSION:Compared with renal tubular epithelial cellinjury group, AV/PI and TUNEL results demonstrated that the apoptotic rate and number of renal tubular epithelial cells were apparently reduced in the adipose-derived stem cells+renal tubular epithelial cells group and 20 mg/L astragaloside-incubated adipose-derived stem cells+renal tubular epithelial cells group. ELISA results displayed that insulin-like growth factor-1 levels were significantly elevated in the 20 mg/L astragaloside-incubated adipose-derived stem cells+renal tubular epithelial cells group (P<0.05). Western blot assay results exhibited that caspase-3 protein levels were noticeably diminished, but Bcl-2 expression was significantly increased in the 20 mg/L astragaloside-incubated adipose-derived stem cells+renal tubular epithelial cells group (P<0.05). Results suggested that astragaloside-incubated human adipose-derived stem cells suppressed the apoptosis of renal tubular epithelial cells induced by cisplatin, which contributes to the early recovery of injured renal tubule. Its protective mechanism was probably associated with the secretion of insulin-like growth factor-1, inhibition of caspase-3 expression and upregulation of Bcl-2 levels.
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Objective CXCR4-overexpressing bone marrow-derived mesenchymal stem cells (CXCR4-BMSC) were constructed and co-cultured with hypoxia/re-oxygenation pretreated renal tubular epithelial cells (HR-RTEC).Repair of HR-RTEC was detected and the possible mechanism was also discussed.Methods CXCR4-BMSC (CXCR4-BMSC/eGFP,eGFP as the tracer gene) and null-BMSC (BMSC/eGFP) were obtained by gene transfection technique,and the level of CXCR4 in the transfected cells was detected.RTEC was cultured under hypoxia/re-oxygenation condition for 12 h,respectively,to obtain HR-RTEC,which was used to simulate AKI in vitro.BMSC and HR-RTEC were co-cultured for 12 h,and the proportion of apoptotic cells among the HR-RTEC was assayed by immunofluorescence technique.Western blot was used to test the protein levels of cleaved Caspase-3 and Bcl-2.The number of migrating BMSC was also assayed.After culturing with the HR-RTEC culture supernatant,the expression of cytokeratin 18 (CK18) in BMSC was tested by immunofluorescence staining.Cytokines including bone morphogenetic protein-7 (BMP-7),hepatic growth factor (HGF) and interleukin-10 (IL-10) in the BMSC culture supernatant were detected by ELISA method.Results Expression of CXCR4 was enhanced in CXCR4-BMSC.Proportions of the apoptotic cells among HR-RTEC after being co-cultured with BMSC,CXCR4-BMSC and null-BMSC were all decreased,especially in the C/H group.The decreased cleaved Caspase-3 and enhanced Bcl-2 were also observed in HR-RTEC.The number of migrating CXCR4-BMSC was the highest.Proportions of CK18+ cells in BMSC,CXCR4-BMSC and null-BMSC were all low and showed no difference.However,CXCR4 overexpression in BMSC stimulated secretions of BMP-7,HGF and IL-10.Conclusions CXCR4-overexpressing BMSC has more repair effect on the co-cultured HR-RTEC,the enhanced migration ability and secretion ability of CXCR4-BMSC are the possible mechanisms.
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Objective To investigate the role of human adipose-derived mesenchymal stem cells (ADSC) cultured with astragaloside Ⅳ(Ast) on renal tubular epithelial cells line (HKC) induced by cisplatin in vitro.Methods HKC was divided into four groups:(1) normal control group; (2)cisplatin group; (3) ADSC and HKC group; (4) ADSC cultured with Ast and HKC group.After coincubated with ADSC,the apoptosis index and proliferation of HKC were detected respectively.The levels of interleukin-6 (IL-6),regulated upon activation normal T cell expressed and secreted (RANTES),erythropoietin (EPO) and insulin like growth factor 1 (IGF-1) were detected by ELISA.Transwell culture system were used to test the migration effect of ADSC.Results Compared with cisplatin group,the apoptotic rates of HKC were decreased and the cell number increased obviously (P ＜ 0.05) in ADSC and HKC group and ADSC cultured with Ast and HKC group.Compared with cisplatin group,the expression of IL-6 and RANTES were lower (P ＜ 0.05),and the level of EPO and IGF-1 increased significantly (P ＜ 0.05),in ADSC cultured with Ast and HKC group.Crystal violet staining showed that ADSC cultured with Ast and HKC group migration index was higher than the other three groups (P ＜ 0.05).Conclusion The intervention of Ast may stimulate paracrine effect and migration of ADSC,so as to reduce apoptosis of HKC.
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Objective To investigate the migration of bone-marrow mesenchymal stem cells (BMSCs) under acute kidney injury (AKI) microenvironment in vitro and the effect of erythropoietin (EPO) intervention,and to explore its underlying mechanism.Methods Renal tubular epithelial cells (RTECs) were cultured in hypoxia/re-oxygenation (HR) condition for 12 h,respectively,in order to establish HR-RTEC.BMSCs and RTECs were co-cultured by Transwell system and were divided into 7 groups:control group (group①,only BMSC cultured),BMSC-RTEC co-culturing group (group ②),BMSC-HR-RTEC co-culturing + EPO intervention groups (group ③to group ⑦,EPO concentration:0,1,5,10,50 IU/ml).All the groups were cultured for 48 h and the number of migrating BMSCs was detected.Western blotting was applied for the detection of SDF-1 expression in RTECs and pMAPK and MAPK levels in BMSCs.SDF-1 concentration in the RTECs culture supernatant was tested by ELISA.Results The number of BMSCs migrating to the low chamber where HR-RTECs were cultured was increased,and EPO intervention further enhanced this migration which reached the peak at the concentration of 10 IU/ml [Compared with group③,(46.67±7.37) cells vs (19.00±2.37) cells,P ＜ 0.05].Intracellular expression level and the secreated level of SDF-1 in HR-RTECs in group③ were higher than those in RTECs of group② [0.37±0.01 vs 0.19±0.01,P ＜ 0.05; (61.64±4.88) μg/L vs (35.26±8.78) μg/L,P ＜ 0.05].EPO intervention increased above SDF-1 levels and reached the peak at the concentration of 10 IU/ml [group⑥ vs group③:(173.53± 14.66) μg/L vs (61.64±4.88) μg/L,P＜0.05],accompanied with enhanced phosphorylation of MAPK in BMSCs.Conclusions AKI microenvironment has obvious chemotaxis effect on BMSCs,and EPO intervention can strengthen this effect.The increased SDF-1 level and enhanced phosphorylation of MAPK,the downstream signal protein of SDF-1/CXCR4 axis,are the possible mechanism for EPO performance.
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ObjectiveTo study the effect of berberine on diabetes or insulin resistance accompanied with reduction of skeletal moscle and wasting in db/db mice.Methods db/db mouse-a model of diabetes/insulin-resistance was studied,with the wild type mouse as control.After being treated with berberine ( 5 mg · kg-1 · d-1 ) for 3 weeks,the muscle size of tibia anterior (TA) of the animals was measured after staining with laminine/Hyosin Heavy chain-Slow using immunochemistry,then observed under fluorescent microscope and calculated with software.The rate of [ 14 C ] -Phenalanine incorporation into the uuscle was measured to analyze the protein synthesis,and the [ 3 H ] -Tyrosine released into the medium was determined in order to analyze protein degradation.The mRNA expressions of muscle atrophy Fbox-1 ( Atrogin-1 ) and muscle ring finger-1 ( MuRF-1 ) were measured by Northern blot.Results With berberine treatment,blood glucose and fat levels were lowered [ ( 18.55 ± 3.79 vs 26.32 ± 4.02 ) mmol/L,P＜0.01 ; ( 2.75 ± 0.30 vs 3.77 ± 0.52 ) g,P＜0.05 ],but tibia anterior muscle weight/length ratio and cross-section area were decreased,rates of protein synthesis in isolated muscles of db/db mice were decreased by 18％ -22％,and the rates of degradation were significantly raised by 24％ -26％ after berberine treatment.There also was increased the transcription and translation of Atrogin-1 and MuRF-1,accompanied with decreased eukaryotic initiation factor 3 subunit (eIF3-f)protein level simultaneously. ConclusionBerberine improves hyperglycemia and insulin resistance by down-regulating blood sugar and body fat,but it causes reduced protein synthesis and minimally enhanced protein degradation.The mechanism might be related to berberine-induced up-regulating Atrogin-1 、MurF-1 and down-regulating eIF3-f.
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Objective To investigate the effect of erythropoietin (EPO) on mesenchymal stem cells (mMSCs) proliferation under acute kidney injury (AKI) microenvironment,and to study its possible mechanism.Methods C57BL/6 mice's MSCs (mMSCs) were isolated by Percoll density gradient centrifugation and adherence cultivation.Surface markers were identified by flow cytometry.AKI mice models were made by clamping bilateral renal pedicles for 30 minutes and reopening for 30 minutes.Then both renal cortex was drew immediately to make IR kidney homogenate supernatant.P3-mMSCs were divided into different groups: Group A: low glucose DMEM medium with 10% fetal bovine serum; Group B: low glucose DMEM medium with 10% fetal bovine serum plus IR kidney homogenate supernatant; Group C: low glucose DMEM medium with 10% fetal bovine serum plus IR kidney homogenate supernatant and different concentrations of EPO (1,5,10,50 U/ml).Each group was incubated for 1 d,3 d,5 d,7 d.Proliferation of mMSCs was detected by CCK-8,and apoptosis was detected by TUNEL.The protein expression of erythropoietin receptor(EPOR) and the proteins of proliferation/apoptosis related signal pathway were examined by Western blotting.Results Under IR kidney homogenate supernatant,the proliferation ability of mMSCs decreased significantly (P＜0.01),while the apoptoic percentage was significantly higher than that of Group A (P＜0.01).After intervention of EPO,mMSCs proliferation enhanced,at the same time,the apoptoic percentage decreased,in a dose-dependent manner.EPOR was positive in P3-mMSCs by Western blotting.EPO decreased the expression of caspase-3 in mMSCs under AKI microenvironment in a dose- and time-dependent manner,but increased the expression of Bcl-2.Cultured for 5 d,the expression of phosphor-Janus kinase2(p-JAK2) [(0.641 ±0.028) vs (0.456±0.012)] and phosphor-signal transducer and activator of transcription(p-STAT5)[(0.398±0.016) vs (0.209±0.020)] was significantly higher in 10 U/ml EPO group compared to group B.Conclusion Erythropoietin can promote proliferation of mMSCs in vitro under AKI microenvironment,which is mediated by EPOR and related with proliferation/apoptosis signal pathway.
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BACKGROUND:The rapidly developed transplantation of peripheral blood stem cells have been successfully used to substitute bone marrow transplantation and become the first choice method for transplantation of hemopoietic stem cells.It is relatively difficult to collect peripheral blood stem cells from young age and low body mass infants.OBJECTIVE:To investigate the safety and adverse effects of peripheral blood stem cell collection from young age and low body mass through the use of blood cell separator.METHODS:Two type 1 diabetes mellitus infants,aged younger than 2 years old and with body mass less than 15 kg,were treated using autologous hemopoietic stem cell transplantation.The two infants were adequately comforted to lesion the fear of collection.At 1 week prior to collection,calcium agent was orally taken to reduce the incidences of low calcium.Within 24 hours prior to collection,oily food was forbidden,and on the day of collection,milk was forbidden,to avoid chylemia,which influences blood collection.Prior to collection,200 mL 25 Gy y-ray radiated red blood cells suspension was injected into the tube,which was routinely placed in the subclavian vein,to avoid hypovolaemic syndrome and the effects on hematocrit.Individualized collection parameters were set,During collection,blood circulation volume was 3,4 times of systemic blood circulation to ensure sufficient total circulation volume.During isolation,the ratio of ACD to whole blood was kept between 1:11 and 1:13 to prevent sodium citrate poisoning.RESULTS AND CONCLUSION:Peripheral blood stem cells were successfully collected during first intention in each infant.During collection,stable vital signs but no adverse effects were observed.After collection,mononuclear cells weighted 14.71×108/kg and 18.82×108/kg respectively,and CD34+ cells were about 34.13×108/kg and 32.38×106/kg,respectively in each infant.Therefore,it is feasible to collect peripheral blood stem cells from infants of young age and low body mass under sufficient psychological preparation.
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Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.
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Bone marrow-derived mesenchymal stem cells (MSCs) have potentials of proliferation, multilineage differentiation and homing to injured tissue and organs. Therefore, many researchers consider them as seed cells and attempt to use them to repair injured tissues and organs. In the allo- even xero-transplantation of these seed cells, graft rejection is an important problem. A large amount of data show that MSCs have specific immune characteristics; they block dendritic cell maturation, decrease immune response of T cells, do not express class Ⅱ major histocompatibility complex molecules, and mediate immunosuppression by secreting some dissoluble factors. The specific low immunogenicity of MSCs could avoid rejection in xero-trensplantation for human and animals in vivo, showing advantages in treatment. Therefore, they are promising to be used as seed cells for kidney construction.
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Objective To find out the epidemic characteristics and the prevalent tendency of transmission of HIV infection in Zhaotong City from 1997 to 2007. Methods Statistical analysis was applied to the data of 1997-2007 Zhaotong City local monitoring detection of HIV-infected persons and AIDS epidemic Tables Network reported. Results From 1997 to 2007, the cumulative report of the city's HIV-infected persons was 914 cases. Before 2002 the report was 144 cases as intravenous drug users. From 2003 to 2007 cumulative reports of 770 cases were infected with HIV, of which 524 were of local detection, accounting for the 68% of reports; field reports were 246 cases, accounting for 31.95%. 260 cases were intravenous drug users, accounting for 33.8%; 155 cases of heterosexual contact, accounting for 20.1%; 20 cases were of mother to child transmission, accounting for 2.6%; 335 were unknown cases, accounting for 43.5%. Report of infection from 0.19/100 000 in 1997 rose to 3.51/100 000 in 2007. The infection rate for migrant workers was 23.43/100 000. Conclusions From 1997 to 2007, transmission of HIV infection in Zhaotong City had a great change, and the rate of infection rose continually. The proliferation from high-risk population groups such as drug user to the general population increased rapidly, and it was the same case with floating population.
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Objective To investigate the application of expanded p01ytetrafluoroethylene(ePTFE)grafts in upper arm to build arteriovenous aCCeSS for hemodialysis. Methods ePTFE graft vascular access was built in the upper arm in 20 uremia patients.Three operation strategies were applied according to the reference,including loop grafts connected axillary artery and axillary vein,straight graft connected axillary artery and elbow basilic vein,and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis.The blood flows were 220-300 ml/min without re-circulation found.Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.
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Objective To observe the effect of different calcium concentration peritoneal dialysate on calcium-phosphorus metabohsm in uremia patients under peritoneal dialysis. Methods Forty uremia patients who the first entered peritoneal dialysis were divided into two groups: standard calcium concentration group (20 cases), low calcium concentration group (20 cases). Treated with continuous ambulatory peritoneal dialysis (CAPD), combining with oral calcium carbonate, observing 12 months. Results When the first entering CAPD, serum calcium, phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH) of the two groups had no differences. Hyperphosphatemia, lower iPTH were universal. After 6 months' treatment, hypercalcemia and hyperphosphatemia in standard calcium concentration group got increasingly serious.While in low calcium concentration group, serum calcium, phosphorus, calcium-phosphorus product all decreased significantly, moreover, they were also lower than post-treatment standard calcium concentration group(P<0.01). In the following 6 months, in low calcium concentration group,serum calcium, calcium-phosphorus product maintained at the normal level serum phosphorus also decreased to the normal level iPTH maintained about 150 ng/L. During the treatment, all patients had no hypotension and hyperspasmia. Conclusion Low calcium concentration peritoneal dialysate can ameliorate disorder of calcium-phosphorus metabohsm, delay the appearance of its comphcations.
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Objective To observe the changes of CD4+CD25+ regulatory T cells, Foxp3 mRNA and soluble interlukin 2 receptor (sIL-2R) in the peripheral blood of kidney transplantation recipients and to evaluate their effect on the diagnosis of acute rejection. Methods Forty-two renal transplant recipients and 30 healthy controls were enrolled in this study. CD4+CD25+ regulatory T cells proportion, Foxp3 mRNA and sIL-2R of pre-transplantation and those of day 7,14, 28, 56 of post-transplantation were measured by flow cytometer, fluorescent quantization PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Biochemistry appliance was used to detect serum creatinine. The diagnosis of acute rejection in transplanted kidney was based on the clinical symptoms, the laboratory examinations, Doppler ultrasound and biopsy. Results (1)At day 7, 14, 28, 56 of post-transplantation, CD4+CD25+ regulatory T ceils proportion, Foxp3 mRNA level in acute rejection group were significantly decreased compared with those in non-acute rejection group. (2) There were significant differences of peripheral blood CD4+CD25+ regulatory Tcells[(9.22±3.53)% vs (6.09±1.99)%, P<0.01], Foxp3 mRNA[(0.82±0.36)×10-3 vs (0.50±0.28)×10-3, P<0.01] and sIL-2R levels [(856.30±108,24) U/ml vs (247.35±11.24) U/ml, P<0.01]between patients of pre-transplantation and healthy control group. (3)Plasma CD4+CD25+ regulatory T cells [(16.53±4.14)%] and the expression of Foxp3 mRNA [(4.97±1.94)×10-3] was significantly increased, but sIL-2R level [(463.72±31.23) U/ml] was significantly decreased as the transplanted renal function was restored (all P<0.01). (4) Plasma CD4+CD25+regulatory T cells [(12.18~2.86)%] and the expression of Foxp3 mRNA [(3.15±1.22)×10-3] was significantly decreased (P<0.01), and sIL-2R level [(748.36±115.41) U/ml] was significantly increased (P<0.01) when acute rejection occurred. The above changes had an earlier onset than the change of Scr. (5)The percentage of CD4+CD25+ regulatory T cells was positively correlated with the Foxp3 mRNA level (P<0.01), but was not correlated with sIL-2R level in all the patients. Conclusion The measurement of these markers in peripheral blood may be an important guideline to the diagnosis and prognosis of acute rejection in renal transplant recipients.