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A case of varicella pneumonia, hepatitis and pancreatitis after kidney transplantation was retrospectively analyzed. One week after kidney transplantation, the patient had a papule with pruritus, which was diagnosed as varicella by dermatologist as well as high-throughput sequencing. The patient was found to have pneumonia, hepatitis and pancreatitis. The individualized treatment regimen was used, including the dosage reduction of immunosuppressive agents, the blood drug concentration monitoring, antiviral therapy, anti-infection therapy, supportive treatment, and symptomatic alleviation for complications. The treatment was adjusted according to the indicators'variation. The timely review of the indicators and immunosuppressant blood concentration were performed to protect the transplanted kidney function, and the patient recovered in time. This rare case of postoperative complications of kidney transplantation were summarized and analyzed in order to accumulate clinical experience for the treatment of renal transplantation.
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Objective:To analyze the immune response in mice after immunization with vaccine of rAd5F35-SIVenvT in combination with rMVA-SIVenvT to evaluate the efficacy of different immunization strategies.Methods:Two recombinant viruses were identified in vitro by PCR and Western blot. The BALB/c mice were immunized with homologous and heterologous immune strategies. The numbers of splenic lymphocytes secreting IFN-γ were measured by ELISPOT assay, meanwhile SIV gp120 antibody titer were measured by ELISA assay. Results:SIVenvT protein was expressed effectively by rAd5F35-SIVenvT and rMVA-SIVenvT in HEK293 cells. The specific immune response reached its peak at 4-week post first immunization, then decreased. SIV Env specific cellular immune response and SIV gp120 specific antibody could be detected at 4-16 weeks post first immunization. The specific cellular response was significant stronger in heterologous immunization group than homologous group at 4 week and 16 week. Furthermore, heterologous immunization induced significant higher titer of SIV gp120 antibody at 4 week than homologous group.Conclusions:Specific immune response induced by rAd5F35-SIVenvT in combination with rMVA-SIVenvT was stronger than homologous vector immunization. The results provided references for further study in nonhuman primates.
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How to reduce the use of immunosuppressant is one of the difficult problems to be solved in the field of organ transplantation. Cell therapy is considered as an effective solution to replace immunosuppressant with a promising clinical application. Regulatory dendritic cell (DCreg) has attracted widespread attention due to its ability to induce immune tolerance. Kidney is a solid and non-immune organ. Whether the particularity of body and the local microenvironment of recipients after renal transplantation affects the application of DCreg is the focus of research. In this article, the application of DCreg in renal transplantation was analyzed from the perspective of renal immunity.
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The hospital introduced a multi-department synergy in management of the rational use of carbapenems. Specifically,the medical affairs department conducts training and appraisal of doctors along with a monthly checkup of medical records. The pharmaceutical affairs division conducts prior prescriptions checkup and follow-up comment. The clinical microbiology laboratory and the hospital-acquired infection management department monitors and releases such infection and bacterial resistance information of the whole hospital in real time. The results showed increased prescriptions of imipenem and cilastatin sodium, and decreased prescriptions of biapenem for injection. Drug resistance analysis showed that carbapenem resistant strains increased by 28%,but the total number of patients reduced by 10% and total number of patients with multidrug resistance remained unchanged. It is proposed to further antimicrobial stewardship in the hospital to achieve rational drug use and curb bacterial resistance.
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Heart specialists team has become one of the core concepts of diagnosis and treatment mode for cardiovascular diseases.Multidisciplinary collaboration has proved its beneficial effects on the diagnosis and treatment strategies, patient selection, follow-up and management of some cardiovascular diseases.At present,it is chiefly seen in the diagnosis and treatment of coronary artery revascularization and transcatheter aortic valve replacement.During implementation there still exist such problems as lack of awareness,attention and effective operation of the medical staff,and lack of an incentive mechanism, thus incurring controversies over such a model.Therefore further follow-up and improvements are expected in combination with the characteristics of China′s medical institutions.
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The laboratories of National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, have developed a series of experimental method . These method have unique advantages over the national standard method and industry standard method . How to make these method become public products through legal procedures to serve disease prevention and control more extensively is an obligatory task for national virological laboratories. This article explores the establishment, verification, validation, and examination of virological non-standard method under laboratory certification and accreditation conditions through empirical research on the " RT-RAA method for detecting EV71/CA16 and other viruses" .
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Objective@#To clarify the potential pathogen for fever of unknown origin (FUO) in serum samples for which pathogenic agents were hardly identified with conventional exainatins.@*Methods@#Random capturing the nucleic acid of pathogen was performed by utilizing the property of sequence non-dependence of next generation sequencing (NGS), followed by enrichment of nucleic acid with multiple displacement amplification (MDA). After sequencing, metagenomic analysis was applied to the raw data and the phylogenetic tree was built to identify the potential pathogen.@*Results@#The result did not indicate common pathogens for FUO but showed the existence of Torque teno Viurs (TTV). Assembly was carried out to all sequencing reads. The coverage of consensus sequence on reference was calculated. Phylogenetic result indicated that all confidence sequences belonged to 3 genera (α TTV, β TTV and γ TTV).@*Conclusions@#The characteristics of genome, phylogenesis of TTV and TTV as signal at immunology level were analyzed and clarified. The possible explanation for detection of TTV in 3 genera may be that TTV itself or non-infectious factors caused the immunosuppression, which finally result e in rise of TTV detection.
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Objective To assess the prognostic value of C-reactive protein/albumin (CRP/Alb) ratio in patients with clear cell renal cell carcinoma (ccRCC).Methods The study comprised 406 ccRCC patients undergoing nephrectomy between January 2003 and December 2012 in our hospital.There were 253 males and 153 females,aged 24-80 years,with a median age of 58 years.There were 355 cases with TNM Ⅰ stage,38 cases with Ⅱ stage,30 cases with Ⅲ stage,3 cases with Ⅳ stage.There were 376 cases with tumor necrosis and 40 cases without tumor necrosis.There were 395 cases of vascular invasion,21 cases without vessel invasion.The correlations among the pretreatment CRP/Alb ratio,clinicopathological parameters,and overall survival (OS) were evaluated.We compared the prognostic value of the CRP/Alb ratio with GPS and mGPS using the area under the curve (AUC).Results CRP/Alb ratio was associated with age at surgery (P =0.007),TNM stage (P ＜ 0.001),tumor necrosis (P ＜ 0.001) and lymphovascular invasion (P ＜ 0.001),and OS (P ＜ 0.001).The multivariate analysis confirmed that the CRP/Alb ratio independently predicted the OS of patients with ccRCC (P ＜ 0.001),the Glasgow prognostic score (GPS) (P =0.001) and modified GPS (mGPS) (P =0.019) were also independent prognostic factors.For predicting 3-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.88,0.84,0.85,0.80.For predicting 5-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.80,0.79,0.76,0.72.The CRP/Alb ratio was superior to GPS and mGPS in predicting the 3-or 5-year survival rate of ccRCC patients.Conclusions The CRP/Alb ratio could be an independent prognostic factor in ccRCC patients.The CRP/Alb ratio could take the place of the GPS and mGPS in terms of predicting prognosis in ccRCC.
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Objective:To transfer the interleukin 37 (IL-37) gene to cervical cancer Hela cells,and to explore the killing effect of IL-37 on the HeLa cells and its enhancement in the chemotherapy sensitivity of HeLa cells.Methods:The pIRES2-EGFP (NC group) and pIRES2-EGFP/IL-37 (IL-37 group) plasmids were transfected into the HeLa cells.Q-PCR and Western blotting methods were used to detect the expression levels of IL-37 mRNA and protein.The activities of HeLa cells in NC group,IL-37 group,DDP group and IL-37+DDP group were detected by CCK8 method,and the inhibitory rates of cells were calculated.The gene expressions of signal transducer and activator of transcription 3 (STAT3) and Cyclin D1 were detected by RT-PCR method.Results:Compared with NC group,the expression levels of IL-37 mRNA and protein in IL-37 group were significantly increased (P＜0.01).The activities of HeLa cells in DDP (5-15 mg · L-1) groups were inhibited after administration for 24-72 h (P＜ 0.01);the inhibitory rates in IL-37 + DDP group were higher than those in DDP group within 48 h after administration (P＜0.05).Compared with IL-37 group,the inhibitory rates in IL-37+DDP group was increased with 96 h after administration (P＜0.05).Compared with NC group,the expression levels of STAT3 and Cyclin D1 mRNA in IL-37 group were significantly decreased (P＜0.01).Conclusion:The over-expression of IL-37 can inhibit the proliferation of cervical cancer cells and enhance the effect of DDP on the chemotherapy of cervical cancer cells which may be related to the down-regulation of the expressions of STAT3 and Cyclin D1 by IL-37.
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Objective:To transfer the interleukin 37 (IL-37) gene to cervical cancer Hela cells,and to explore the killing effect of IL-37 on the HeLa cells and its enhancement in the chemotherapy sensitivity of HeLa cells.Methods:The pIRES2-EGFP (NC group) and pIRES2-EGFP/IL-37 (IL-37 group) plasmids were transfected into the HeLa cells.Q-PCR and Western blotting methods were used to detect the expression levels of IL-37 mRNA and protein.The activities of HeLa cells in NC group,IL-37 group,DDP group and IL-37+DDP group were detected by CCK8 method,and the inhibitory rates of cells were calculated.The gene expressions of signal transducer and activator of transcription 3 (STAT3) and Cyclin D1 were detected by RT-PCR method.Results:Compared with NC group,the expression levels of IL-37 mRNA and protein in IL-37 group were significantly increased (P＜0.01).The activities of HeLa cells in DDP (5-15 mg · L-1) groups were inhibited after administration for 24-72 h (P＜ 0.01);the inhibitory rates in IL-37 + DDP group were higher than those in DDP group within 48 h after administration (P＜0.05).Compared with IL-37 group,the inhibitory rates in IL-37+DDP group was increased with 96 h after administration (P＜0.05).Compared with NC group,the expression levels of STAT3 and Cyclin D1 mRNA in IL-37 group were significantly decreased (P＜0.01).Conclusion:The over-expression of IL-37 can inhibit the proliferation of cervical cancer cells and enhance the effect of DDP on the chemotherapy of cervical cancer cells which may be related to the down-regulation of the expressions of STAT3 and Cyclin D1 by IL-37.
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Therapeutic HIV vaccine was considered as a hopeful curative method for AIDS patients. However, there is still no suitable HIV animal model for vaccine study since the difference in the immune system between human and animals. To evaluate the therapeutic effect of combined immunization strategy with multiple vector vaccines in macaque models. Plasmid DNA, recombinant Ad5 and MVA vaccines which expressing SIV gag and env genes were constructed. Sequential and repeated immune strategy were applied to immunize mice with these three vaccines. Cellular immune responses in mice immunized with these three vaccines were measured by ELISPOT test in vitro and CTL assay in vivo. The results were analyzed and compared with different antigen combination, order of vaccines and intervals to choose a suitable immunization strategy for macaque immunization in future. It indicated that strong SIV-Gag/Env-specific cellular immune responses were induced by these three vector vaccines. It laid a foundation for evaluating the therapeutic effect of combined immunization strategy with multiple vector vaccines in SIV infected macaque models.
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Animales , Femenino , Humanos , Ratones , Vacunas contra el SIDA , Genética , Alergia e Inmunología , Adenoviridae , Genética , Metabolismo , Anticuerpos Antivirales , Alergia e Inmunología , Productos del Gen env , Genética , Alergia e Inmunología , Productos del Gen gag , Genética , Alergia e Inmunología , Vectores Genéticos , Genética , Metabolismo , Infecciones por VIH , Alergia e Inmunología , Virología , Inmunización , Ratones Endogámicos BALB C , Virus de la Inmunodeficiencia de los Simios , Genética , Alergia e Inmunología , Vacunas de ADN , Genética , Alergia e InmunologíaRESUMEN
The compensation mechanism reform is the key and difficult point of the public hospital reform.Although current health care reform has been carried out including strengthening public welfare of public hospitals and adjusting the compensation mechanism,the effect is not very obvious.How to conduct the compensation mechanism reform orderly and smoothly has become an important topic.I have analyzed the historical evolution,the status and problems of the hospital compensation mechanism.On the basis I have made views and suggestions about the current drive and the path optimization for the compensation mechanism reform.
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There are three kinds mainly of the present government worldwide management of public hospital management system and public service system.This paper compares the management system of public hospitals of the United States of America,Britain,Singapore and other countries,discussion of foreign public hospital public welfare system arrangement.With a view to put forward effective suggestions for the reform of public hospitals in China and public hospital regression public.
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To explore the serum miR-338-5p expression characteristics in renal transplant recipients ,and the role of regulating BAFF signal ,then investigate its biological significance.Methods:Healthy volunteers were enrolled as control group.Serum miR-338-5p was detected by real-time PCR;soluble BAFF was detected by ELISA;anti-HLA-Ⅰantibody,anti-HLA-Ⅱ antibody and anti-MICA antibody were detected by liquid chip technology.SPSS17.0 software was applied.t-test was used to compare the means of two independent samples;Paired samples t-test was used to compare the means of two paired samples;Spearman method and Pearson method were used to analyse the correlation;P<0.05 was considered to be statistically significant.Results: Compared with healthy controls,serum miR-338-5p in renal transplant recipients decreased significantly (P<0.001),while serum BAFF increased significantly (P<0.01).Serum miR-338-5p levels within 1 year post-transplantation were significantly lower than that of more than 1 year post-transplantation (P<0.01);Serum miR-338-5p levels within 3 years post-transplantation were significantly lower than that of more than 3 years post-transplantation (P<0.01);To all research objects,serum miR-338-5p was significantly negatively correlated with serum BAFF (r=-0.51,P<0.001),and serum miR-338-5p was significantly negatively correlated with anti-HLA-Ⅱ antibody(r=-0.322, P<0.05);Serum miR-338-5p within 3 years was significantly negatively correlated with anti-HLA-Ⅱantibody (r=-0.423,P<0.05), and serum miR-338-5p within 3 years was significantly negatively correlated with anti-MICA antibody(r=-0.411,P<0.05);Serum miR-338-5p more than 3 years was significantly positively correlated with anti-MICA antibody(r=0.486,P<0.05),and Serum miR-338-5p more than 3 years was significantly positively correlated with anti-HLA & MICA antibody(r=0.578,P<0.01).Conclusion:miR-338-5p may directly or indirectly target BAFF signal ,and participate antibody mediated immune response by regulating its target genes and interfere with the long-term survival of transplanted renal.
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Objective To detect the expression and correlation of serum Hepcidin,IL-6,sTfR,BMP6 diversity and explore the role of serum Hepcidin in prostate cancer with bone metastasis.Methods From January 2012 to March 2012,serum Hepcidin,IL-6,sTfR,BMP6 diversity were tested by ELISA in 25 prostate cancer patients with bone metastasis,30 prostate cancer patients without bone metastasis and 30 patients with BPH were used as the control group.The mean patient's age was 67 years (range from 55 to 75 years).In prostate cancers with bone metastasis group,the mean PSA base line was 138.0 μg/L (ranged from 20.0-1500 μg/L),the prostate cancers without bone metastasis group,mean PSA was 10.2 μg/L(ranged from 3.5-28.2 μg/L),and in BPH group,the mean PSA was 3.7 μg/L (ranged from 0.3-14.2 μg/L).Venous blood samples were taken in fasting mornings,then stored 3 ml in EDTA anticoagulant vacuum tube and centrifuged at4 ℃ for 10 min,the isolated serum were then preserved in-80 ℃ refrigerator.The competitive in-phase enzyme-linked immunoassay (ELISA) was used to detect serum Hepcidin,IL-6 and sTfR and BMP6 levels.Results Serum Hepcidin expressions in three groups were 67.7 ± 40.6 μg/L,37.5 ± 15.3 μg/L and 34.3 ± 10.7 μg/L,respectively.For prostate cancers with bone metastasis group,serum Hepcidin expression were higher than control group (P ＜ 0.05),and associated with IL-6(22.5 ±22.1 μg/L),sTfR (5.7 ± 2.6 μg/L),BMP6 (429.3 ± 188.4 μg/L),correlation coefficients were 0.972,-0.987,0.971 (P ＜ 0.05).Conclusions Increased serum Hepcidin level might be a sensitive index for diagnosis and prognosis of prostate cancers with bone metastasis.
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MicroRNAs (miRNAs) are evolutionary conserved non-coding RNA molecules.They involve in a variety of biological processes such as regulating the individual development,cell division,differentiation,apoptotic and fat metabolism through post-transcription pathway.It has been shown that miRNAs play important roles in the development and progression of many tumors,including of renal carcinoma,miRNAs play functions similar to oncogenes or anti-oncogenes in the development and progression of renal carcinoma by regulating the signaling pathway of its target genes involving in.
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Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.
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Objective To observe the level of serum hepcidin and the relationship of hepcidin with renal anemia and micro-inflammation state in peritoneal dialysis(PD) patients.Methods Serum hepcidin,interleukin-6(IL-6),soluble transferrin receptor (sTfR) and erythropoietin (EPO) were measured in 50 PD patients with anemia,30 PD patients without anemia and 40 cases of normal control by ELISA.The indexes of blood routine examination,biochemistry and iron metabolism were also detected at the same time.Results The level of hepcidin in PD patients was significantly higher than that in normal control[(103.65±43.6) μg/L vs (56.39±35.7) μg/L,P ＜ 0.05].Furthermore,the level of hepcidin in PD patients with anemia was higher than that in PD patients without anemia [(122.67±36.6) μg/L vs (83.65±26.4) μg/L,P ＜ 0.05].The results of correlation analysis showed that serum IL-6,sTfR,EPO and ferritin were positively correlated with hepcidin(R =0.821,0.742,0.711,0.531,all P ＜ 0.05),while creatinine clearance of residual kidney in 24 hours and hemoglobin were negatively correlated with hepcidin(R =-0.533,-0.685,all P ＜ 0.05).Conclusions The higher level of hepcidin in PD patients is related with the residual renal function and the micro-inflammatory state.The higher level of hepcidin may induce the iron metabolism imbalance,and then influence the state of renal anemia.The adjustment of hepcidin may provide clinical research value of improving renal anemia and micro-inflammatory state in PD patients.
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Objective To explore the significantly differentially.expressed microRNAs during antibody-mediated renal allograft rejection.Method MicroRNA array assay was used,and the obtained data were analyzed by bioinformatics analysis.The obtained significant microRNAs were further analyzed to forecast the targeted genes in the common database,then experimental means were used to testify the targeted genes.Result During the antibody-mediated renal allograft rejection,the significantly over-expressed microRNAs were miR-200c,miR-200b,miR-30c,miR-30b and miR-30e+,etc.The significantly down-expressed microRNA was miR-338-5p.The bioinformatics analysis results indicated that TRAF3 was the targeted gene of miR-338-5p,which was testified by real time PCR,immunohistochemical assay and fluorescence reporter assay.Conclusion miR-338-5p anticipated in the antibody-mediated renal allograft rejection by targeting TRAF3.
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Objective To evaluate the feasibility and effectiveness of bladder-preserving local resection combined with intra-artery chemotherapy for patients with T1G3 bladder cancer.Methods Thirty five cases with T1G3 bladder cancer were analyzed retrospectively. Patients were all treated by bladder-preserving local resection combined with intra-artery chemotherapy. Results Thirty five cases were followed up. The time of follow-up ranged from 7 to 116 months,and mean time was(66.0±18.3)months.The 5 year recurrence and bladder-preserving rate were 48.6 ％(17/35)and 68.6 ％(24/35),respectively.The overall and tumor specific survival at 5 years was 77.1％ (27/35)and 82.9 ％ (29/35).The effect of bladder-preserving local resection plus intra-artery chemotherapy was satisfactory. Moreover, intra-artery chemotherapy had no obvious side effects.Conclusion Bladder-preserving local resection combined with intra-artery chemotherapy not only can retain normal bladder function, decrease in the recurrence, but also does not reduce the survival rate. It is an effective treatment for some patients with T1G3 bladder cancer instead of cystectomy over-treatment.