The Abnormal High Expression of B Cell Activating Factor Belonging to TNF Superfamily （BAFF） and Its Potential Role in Kidney Transplant Recipients

B cell activating factor belonging to TNF superfamily （BAFF） is a critical regulator of B cell maturation and survival In this present study, the expression characteristic of BAFF in kidney transplantation recipients was investigated, its potential significance was analyzed and peripheral blood of follow-up kidney transplant recipients was studied. Flow cytometric assay results showed that, cell-surface BAFF was significantly highly expressed on peripheral CD3＋ T lymphocytes in 〉 5 yrs group of kidney transplant recipients, compared with other groups （p 〈 0.05）. BAFF expression could be found on CD4＋ T cells and CD8＋ T cells. The BAFF mRNA levels in peripheral mononuclear cells were consistent with the protein levels. However, serum soluble BAFF levels were inter- individually different in each group. Stratified by renal function, it was found that cell-surface BAFF levels were significantly higher in those with abnormal renal function, compared with recipients with normal renal function （p 〈 0.05）. ELISA assay results showed that expression levels of cell surface BAFF were significantly correlated with anti-HLA I ＆ II antibodies. These results indicate that BAFF may be involved in the development of graft-loss and influences the long-time outcome of kidney allografl, likely mediated by interfering with immune response. Cellular ＆ Molecular Immunology. 2008;5（6）：465-470.     

热缺血20 min猪心脏死亡供体心冠状动脉内皮功能的变化

BACKGROUND: Myocardial and coronary endothelial injury occurs in donor hearts due to warm ischemia during cardiac transplantation. Coronary endothelial structure and function play a critical role in long-term outcomes for patients after cardiac transplantation.  OBJECTIVE: To study the effect of hypoxia-induced warm ischemia (20 minutes) on coronary endothelial function of porcine donor hearts after cardiac death (DCD). METHODS: Sixteen healthy Swedish domestic pigs were randomized into control (n=6), DCD (n=5), and DCD plus cold storage (n=5) groups, respectively. A DCD model in pigs was established using the method of hypoxia-induced 20-minute warm ischemia in the DCD and DCD plus cold storage groups. Isolation of the heart left anterior descending coronary artery or combined with heart preservation pretreatment for 4 hours was performed in the DCD and DCD plus cold storage groups. The maximum coronary endothelium-dependent relaxation was determined in the three groups. RESULTS AND CONCLUSION:There were no significant differences in the maximum coronary endothelium-dependent relaxation and the minus logarithmic of substance concentration induced 50%maximal relaxation among three groups (P > 0.05). These results indicate that 20-minute warm ischemia cannot lead to obvious coronary endothelial dysfunction. In addition, DCD combined with 4-hour cold storage does not affect coronary endothelial function. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Complications and death causes of peripheral blood stem cell transplantation in the treatment of thalassemia major北大核心

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is the only effective method to cure thalassemia major. However, the risk factors influencing the prognosis of transplantation remain unclear. OBJECTIVE: To analyze the distribution of common complications and cause of death after allogeneic hematopoietic stem cell transplantation in children with thalassemia major, and to explore the prognostic factors so as to provide references for improving the survival rate of patients. METHODS: This retrospective cohort study included 257 patients with β-thalassemia major who underwent allogeneic hematopoietic stem cell transplantation at Department of Hematology and Oncology, Guangzhou Women and Children Medical Center between September 2013 and September 2019. There were 172 males and 85 females, with a median age of 6 years at the time of transplantation. The basic clinical data before transplantation and complications after transplantation were compared between the surviving group and dead group using single factor. The overall survival rate was analyzed by the Kaplan-Meier method, and the overall survival rate was compared by the Log-rank test. Multivariate Cox regression was used to analyze factors affecting survival. RESULTS AND CONCLUSION: The median follow-up time was 29 months, and no cases were lost to follow-up. (1) Univariate analysis results showed that there were significant differences in the risk classification between surviving patients and dead patients (P=0.033). Patients with higher risk class had an increased risk of death after transplantation. Multivariate analysis showed that risk classification and severe pneumonia were independent risk factors for overall survival after thalassemia major hematopoietic stem cell transplantation (P < 0.05). (2) Among 20 dead patients, there were 13 patients with severe pneumonia and respiratory failure, 2 patients with grade IV intestinal graft-versus-host disease, 1 patient with intracranial hemorrhage due to thrombocytopenia, 1 patient with thrombocytopenia with acute pulmonary hemorrhage, 1 patient with sepsis with shock, and 1 patient with myasthenia gravis. (3) Totally 17 cases died within 1 year after transplantation, while the rest 3 patients died of severe pneumonia more than 1 year after transplantation. (4) The incidence of bronchiolitis obliterans was significantly higher in patients who died after transplantation than in those who survived (P < 0.000 1). (5) It is concluded that the important factors that affect survival rate in thalassemia major patients after hematopoietic stem cell transplantation are infection and severe graft-versus-host disease. The risk of death increased in patients with bronchiolitis obliterans after transplantation. © 2023, Chinese Journal of Tissue Engineering Research. All rights reserved.     

肝移植及腹部多器官移植手术的成分输血

BACKGROUND: The liver transplantation and abdominal multiple organ transplantation are complicated surgeries, characterized by massive blood loss and high blood transfusion requirements. OBJECTIVE: To explore the characteristics of blood loss and blood transfusion in liver transplantation and abdominal multiple organ transplantation and post-operative survival rate. METHODS: Clinical data from 192 patients were retrospectively analyzed, including blood transfusion data with the first 24 hours after surgery and post-operative survival rate. RESULTS AND CONCLUSION: These 192 patients included 177 patients receiving liver transplantation,    2 patients receiving liver and kidney transplantation and 13 patients receiving abdominal multiple organ transplantation. The average intra-operative blood loss of each patient was (2 401.5±3 239.5) mL. The average infusion of red blood cells, platelet, cryoprecipitate and frozen plasma of each patient at the first 24 hours after surgery was (11.3±11.9), (0.8±0.9), (10.7±11.7) U and (2 805.5±1 393.1) mL, respectively. All kinds of blood infusion in the liver cancer group were obviously less than those in the hepatic failure group. The infusion of cryoprecipitate and frozen plasma in the cirrhosis group was obviously less than that in the hepatic failure group, but the infusion of platelet in the cirrhosis group was significantly more than that in the liver cancer group. The infusion of red blood cells from July 2013 to June 2015 was significantly less than that from July 2012 to June 2013. The blood loss, infusion of red blood cells and frozen plasma in the liver transplantation group of cirrhosis were significantly more than those in the abdominal multiple organ transplantation group of cirrhosis (all P < 0.05). In conclusion, diagnosis of liver diseases, and the maturity of surgery exert an effect on the blood loss and blood infusion. As the development of liver transplantation and abdominal multiple organ transplantation, both the blood loss and blood infusion are decreased. Besides, compared with liver transplantation, the blood loss and blood infusion show no increase in the abdominal multiple organ transplantation. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

过度疲劳状态下运动性猝死模型大鼠甲状腺及心脏功能变化

BACKGROUND: Exercise fatigue can lead to lactic acid accumulation, metabolism decrease and energy intake disturbance following by overtraining. Further, constant development of negative superposition after overtraining will contribute to karoshi and exercise-induced sudden death. OBJECTIVE:To investigate the changes of rat thyroid function under excessive fatigue state and to further explore the relationship between the exercise-induced sudden cardiac death and thyroid function. METHODS: Seven rats were randomly selected from 30 male Sprague-Dawley rats as blank control group. The remaining rats were trained continuously with exhaustive loaded-swimming exercises to achieve the excessive fatigue state, and seven as fatigue group, seven as sudden death group. Rat samples were collected immediately after exercise to observe the morphology, structure and intercellular substance changes of thyroid follicular epithelial cells and cardiac muscle fibers by hematoxylin-eosin staining;   levels of serum triiodothyronine (T3), tetraiodothyronine (T4), thyroid stimulating hormone (TSH) and lactic dehydrogenase 2 (LDH-2) were detected by ELISA. RESULTS AND CONCLUSION:(1) In the sudden death group, intermyocardiac vessels expanded extremely, some thin myocardial fibers ruptured, and severe congestion and hemorrhage occurred; thyroid follicles were in a hypochromatism with loose intercellular substance, and extensive visible vacuolization in the follicular colloid. (2) The levels of serum LDH-2 and T3 in the sudden death group were significantly higher than those in the blank control group (P < 0.05). (3) The levels of serum T4 and TSH were the highest in the fatigue group, followed by sudden death group, and lowest in the blank control group (P < 0.05). (4) These results suggest that excessive fatigue caused by long-term high-intensity training will lead to thyroid morphological abnormality and myocardial impairment. Increasing serum LDH-2 following excessive fatigue aggravates myocardial damages. Fatigue accumulation causing thyroid dysfunction, abnormal secretion of TSH, T3 and T4, may be one of the causes of exercise-induced sudden death. Exercise-induced sudden death belongs to a multiple organ dysfunction syndrome, and turbulence of thyroid causing cardiac structural and functional alteration may induce sudden cardiac death. 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程     

Transplantation of Human Bone Marrow Mesenchymal Stem Cell Ameliorates the Autoimmune Pathogenesis in MRL/Ipr Mice

Recent evidence indicates that mesenchymal stem cells （MSC） possess immunosuppressive properties both in vitro and in vivo. We previously demonstrated the functional abnormality of bone marrow derived MSC in patients with systemic lupus erythematosus （SLE）. In this study, we aimed to investigate whether transplantation of human bone marrow derived MSC affects the autoimmune pathogenesis in MRL/Ipr mice. We found that human MSC from healthy donors reduced the proliferation of T lymphocytes from MRL/Ipr mice in a dose-dependent fashion. Two weeks after in vivo transfer of MSC, we detected significantly reduced serum levels of anti ds-DNA antibodies and 24 hour proteinuria in MRL/Ipr mice as compared with control groups without MSC transplantation. Moreover, flow cytometric analysis revealed markedly reduced number of CD4＋ T cells while increased Thl subpopulation in MSC group and MSC ＋ CTX group when compared with controls. Histopathological examination showed significantly reduced renal pathology in MSC-treated mice. Immunohistochemical studies further revealed reduced expression of TGF-~, FN, VEGF and the deposition of complement C3 in renal tissue after MSC and MSC ＋ CTX treatment. Taken together, we have demonstrated that transplantation of human MSC can significantly inhibit the autoimmune progression in MRL/Ipr mice. Cellular ＆ Molecular Immunology. 2008;5（6）：417-424.     

骨髓间充质干细胞修复系膜增生性肾炎：作用及机制

BACKGROUND: Bone marrow mesenchymal stem cells are likely to repair renal injury by differentiating into renal parenchymal cells. OBJECTIVE: To explore the effect and mechanism of bone marrow mesenchymal stem cells in the renal repair after mesangial proliferative glomerulonephritis. METHODS: Thirty Sprague-Dawley rats were randomized into normal group, model group and treatment group (n=10 per group). Model group and treatment group were treated with tail vein injection of mouse anti-rat monoclonal antibody Thy1.1 to prepare mesangial proliferative glomerulonephritis models. One week after modeling, rats in the treatment group were given 2×106 bone marrow mesenchymal stem cells via the tail vein, and rats in the other two groups were given the same volume of normal saline. Two weeks after transplantation, urinary protein, urea nitrogen, creatinine levels were detected; hematoxylin-eosin staining was used for observing pathological changes of the renal tissue under microscope; and the expression of transforming growth factor beta 1 was detected by immunohistochemistry method. RESULTS AND CONCLUSION: The levels of urinary protein, urea nitrogen and creatinine as well as the expression of transforming growth factor beta 1 in the renal tissue arranged in descending order were listed as follows: model group > treatment group > control group, and there were significant differences among three groups (P < 0.05). In the model group, diffuse glomerular hyperplasia was observed with the presence of increased extracellular matrix, partial glomerular sclerosis, and interstitial infiltration of inflammatory cells; in the treatment group, glomerular hyperplasia, mesangial proliferation and inflammatory cell infiltration were all mitigated compared with the model group. Therefore, bone marrow mesenchymal stem cell transplantation may contribute to renal repair after mesangial proliferative glomerulonephritis, by inhibiting overexpression of transforming growth factor beta 1 in the kidney. 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程      

Endotoxin impairs the engraftment of rat islets transplanted beneath the kidney capsule of C57BL/6-mice

The primary objective of this investigation was to determine the effect of endotoxin on islet xenograft survival within the first three days after transplantation. Pancreatic islets from Lewis rats were prepared under endotoxin-free conditions with Liberase (Boehringer) and purified by centrifugation on endotoxin-free Ficoll/Histopaque. After overnight incubation, with or without 10 μg/ml endotoxin, the islets were transplanted beneath the kidney capsule of normoglycemic C57Bl/6-mice. Three days later, kidneys were removed and their insulin content were measured. We could demonstrate significant differences (P<0.01) in insulin recovery between lipopolysaccharide-free and lipopolysaccharide-containing grafts. In case of endotoxin contaminated islets, we found only 13±2% (n=9) of the original insulin content, in contrast to 53±7% (n=9) when endotoxin-free islets where grafted. In experiments with islets isolated by use of conventional (lipopolysaccharide-containing) collagenase, and then cultured in endotoxin-free medium, insulin recovery three days after transplantation was 36±1% (n=13).     

低氧预处理诱导骨髓间充质干细胞Pim-1激酶高表达抑制细胞凋亡

BACKGROUND: Bone marrow mesenchymal stem cells have a low survival rate after implanted into the ischemic myocardium. However, hypoxia preconditioning (HPC) may enhance bone marrow mesenchymal stem cell proliferation and promote its survival rate. OBJECTIVE: To explore whether Pim-1 is involved in HPC protecting against apoptosis of bone marrow mesenchymal stem cells and the relevant mechanism. METHODS: Bone marrow mesenchymal stem cells were respectively subjected to HPC for 0, 6, 12, and 24 hours. The expression of Pim-1 and apoptosis-related genes were detected by RT-qPCR and western blot. Then, the best hypoxic preconditioning time was determined as 12 hours. Then, bone marrow mesenchymal stem cells were assigned to one of the following groups: control (without HPC), 12-hour HPC, 12-hour HPC+Pim-1 inhibitor groups. Flow cytometry analysis was used to detect the cell apoptosis, Transwell assay to analyze the cell migration ability in each group, and JC-1 kit to detect mitochondrial membrane potential. Animal models of myocardial infarction were established. One week after modeling, bone marrow mesenchymal stem cells were given via multi-point injection around the infarct zone of rats. Two weeks after modeling, heart tissues of rats were taken and sliced followed by DiI staining to calculate the survival rate of bone marrow mesenchymal stem cells. Additionally, rat cardiac function was assessed by echocardiography prior to and after modeling as well as at 4 weeks after cell transplantation. RESULTS AND CONCLUSION: At 12 hours after HPC, the expression of Pim-1, p-Akt and Bcl-2 gene in the infarct region was significantly increased, but the expression of caspase-3 and Bax was significantly decreased. Compared with the control group, cell viability in the 12-hour HPC group was increased very significantly at 1 week after cell transplantation (P < 0.001), the migration and anti-apoptosis ability were enhanced significantly (P < 0.01) and the cardiac function of rats was significantly improved in the 12-hour HPC group (P < 0.05). All of these protective effects were blocked by the Pim-1 inhibitor. These findings indicate that HPC can protect bone marrow mesenchymal stem cells from apoptosis through activating Akt and up-regulating Pim-1, and thereby improve the therapeutic effect of bone marrow mesenchymal stem cell transplantation on ischemic heart diseases. 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程      

Deficiency of Mouse CD4^＋CD25^＋Foxp3^＋ Regulatory T Cells in Xenogeneic Pig Thymus-Grafted Nude Mice Suffering from Autoimmune Diseases

Xenogeneic thymus transplantation can efficiently induce specific immune tolerance to donor antigens in athymic recipients. However, many nude mice suffer from autoimmune diseases （AID） for over 10 weeks after xenogeneic thymus transplantation. CD4^＋CD25^＋Foxp3^＋ regulatory T （Treg） cells were recently determined to play a pivotal role in keeping immune tolerance in humans and mice. Thus, we investigated this subpopulation of Treg cells in the periphery of pig thymus-grafted nude mice suffering from AID. Our results showed that the expression of Foxp3, CTLA-4 and GITR on mouse CD4^＋CD25^＋ T cells and the ratio of CD4^＋CD25^＋Foxp3^＋ Treg cells to CD4^＋ T cells were significantly decreased in the periphery of pig thymus-grafted nude mice suffering from AID, compared with healthy pig or mouse thymus-grafted nude mice. Furthermore, mouse CD4^＋CD25^＋ T cells in pig thymus-grafted nude mice suffering from AID showed more severe deficiency in immunosuppressive function compared with the counterpart in xenogeneic pig or syngeneic thymus-grafted nude mice without AID. Thus, the decreased frequency, altered phenotype and functional deficiency of mouse CD4^＋CD25^＋ Treg cells in pig thymus-grafted nude mice may contribute to the development of AID in this model.     

建立器官移植随访系统提高临床资料管理水平

器官移植随访系统是针对专科疾病特点的特殊数据管理系统,作为医院管理系统的补充,协助医师分析判断、做出正确决策。通过建立《通用器官移植管理系统》,实现了：与医院管理系统数据接口,自动采集数据;全面收纳所有检验数据;内建数据挖掘工具,协助从海量数据中提取有用部分,进行临床科研工作。该系统的应用提高了我院器官移植患者临床资料管理水平。     

A simplified experimental model of large-for-size liver transplantation in pigs

OBJECTIVE:

The ideal ratio between liver graft mass and recipient body weight for liver transplantation in small infants is unknown; however, if this ratio is over 4%, a condition called large-for-size may occur. Experimental models of large-for-size liver transplants have not been described in the literature. In addition, orthotopic liver transplantation is marked by high morbidity and mortality rates in animals due to the clamping of the venous splanchnic system. Therefore, the objective of this study was to create a porcine model of large-for-size liver transplantation with clamping of the supraceliac aorta during the anhepatic phase as an alternative to venovenous bypass.

METHOD:

Fourteen pigs underwent liver transplantation with whole-liver grafts without venovenous bypass and were divided into two experimental groups: the control group, in which the weights of the donors were similar to the weights of the recipients; and the large-for-size group, in which the weights of the donors were nearly 2 times the weights of the recipients. Hemodynamic data, the results of serum biochemical analyses and histological examination of the transplanted livers were collected.

RESULTS:

The mortality rate in both groups was 16.5% (1/7). The animals in the large-for-size group had increased serum levels of potassium, sodium, aspartate aminotransferase and alanine aminotransferase after graft reperfusion. The histological analyses revealed that there were no significant differences between the groups.

CONCLUSION:

This transplant method is a feasible experimental model of large-for-size liver transplantation.     

阿伦和达珠单抗与抗胸腺蛋白对肾移植的有效性及安全性比较

背景：免疫抑制剂是通过影响机体的体液免疫和细胞免疫抑制机体的免疫功能来完成抗急性排斥反应,提高人/肾存活率。 目的：比较3种免疫抑制诱导剂阿伦单抗、达珠单抗和抗胸腺蛋白在肾移植免疫诱导中的有效性与安全性。 方法：运用Cochrane系统评价法,检索1966年至2011年PUBMED,EMBASE等数据库。纳入阿伦单抗、达珠单抗和抗胸腺蛋白3种药物在肾移植中的随机对照试验(RCT)进行Meta分析。 结果与结论：9个RCT的777例患者纳入分析,3种药物24个月的人/肾存活率和急性排斥发生率差异无显著性意义(均P > 0.05)。随访36个月时,阿伦单抗感染率显著低于抗胸腺蛋白(P < 0.05)。分析结果表明,3种药物的免疫诱导效果相近;随访36个月时,阿伦单抗较抗胸腺蛋白的感染率低。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

上海市器官移植临床医学中心网站的开发

介绍上海市器官移植临床医学中心网站的开发和应用,该网站不仅是展示医学中心形象的窗口,而且率先在网络上提供器官移植随访服务,大大提高了术后随访工作的效率,保证了医疗信息的准确性和及时性,提升了医疗服务的质量,受到广大移植患者的欢迎。     

改进SD-Wistar大鼠肾移植慢性排斥模型的造模方法

背景：国际上常用的肾移植慢性排斥模型是Fisher→Lewis大鼠肾移植模型等,但这些模型在国内均较难以获得并且价格昂贵,大规模使用受到了一定的限制。目的：探索建立SD→Wistar大鼠肾移植慢性排斥模型的新方法。方法：将56对SD→Wistar大鼠作左肾原位移植,受体自身右肾保留作为内对照。23只成功移植的受体大鼠随机分为模型组(n=15)和对照组(n=8)。模型组大鼠在移植后给予10 d的小剂量环孢素微乳化剂[2 mg/(kg·d),腹腔注射],对照组大鼠未给予免疫抑制治疗。结果与结论：对照组大鼠所有移植肾均在4周内出现不可逆的急性排斥反应,移植肾坏死;模型组大鼠移植后4,8,12周时均可见移植肾中出现中等度的炎症细胞浸润,在移植后12周内出现典型的慢性排斥组织病理学改变,其Banff总分随移植后时间的延长而升高。2组大鼠所有受体的自身右肾均没有出现组织病理学改变。模型组大鼠移植后第4天环孢素浓度谷值为(153.2±17.1) μg/L。说明通过给予肾移植的SD→Wistar大鼠受体10 d小剂量的环孢素微乳化制剂(2 mg/kg),可使移植肾出现中等度的炎症细胞浸润并于12周内形成慢性排斥的典型组织病理学改变,可作为研究肾移植慢性排斥的动物模型。中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程     

Trend and outcome of Korean patients receiving overseas solid organ transplantation between 1999 and 2005

The disparity between patients awaiting transplantation and available organs forced many patients to go overseas to receive a transplant. Few data concerning overseas transplantation in Korea are available and the Korea Society for Transplantation conducted a survey to evaluate the trend and outcome of overseas transplantation. The survey, conducted on June 2006, included 25 hospitals nationwide that followed up patients after receiving kidney transplant (KT) or liver transplant (LT) overseas. The number of KT increased from 6 in 2001 to 206 in 2005 and for LT from 1 to 261. The information about overseas transplant came mostly from other patients (57%). The mean cost for KT was $21,000 and for LT $47,000. Patients were admitted for 18.5 days for KT and 43.4 days for LT. Graft and patient survival was 96.8% and 96.5% for KT (median follow up 23.1 months). Complication occurred in 42.5% including surgical complication (5.3%), acute rejection (9.7%) and infection (21.5%). Patient survival for LT was 91.8% (median follow up 21.2 months). Complication occurred in 44.7% including 19.4% biliary complication. Overseas KT and LT increased rapidly from 2001 to 2005. Survival of patients and grafts was comparable to domestic organ transplantation, but had a high complication rate.     

Patterns of schwann cell myelination of axons within the spinal cord

Patterns of Schwann cell myelination of long-projecting axons in the spinal cord were studied. The goal was to determine if such axons arising from neurons whose somata and processes are normally confined to the central nervous system can interact effectively with Schwann cells, the myelinating cells of the peripheral nervous system. In one paradigm Schwann cells develop in the dorsal funiculi of the lumbar spinal cord subsequent to radiation-induced alterations in development of the glial populations. Light and electron microscopic evaluations were made in the region of the corticospinal tracts (CSTs), which in the rat occupy the base of the dorsal funiculi. At 90 days following irradiation, larger axons of these tracts (> 1.5 μm in diameter) were myelinated by Schwann cells, and smaller axons were ensheathed by them. In the second paradigm cultured Schwann cells were injected into the medial portions of the ventral funiculi at 13 days post-irradiation when the glial population was markedly reduced. Earlier investigations from this laboratory demonstrated that Schwann cells do not develop in the irradiated ventral funiculi, as they do dorsally. When placed in proximity to long-projecting axons in the medial portion of the ventral funiculi, the Schwann cells either formed compact myelin sheaths or ensheathed axons, depending upon their diameter. Fasciculation and presence of collagen were characteristic of this paradigm but were absent from the Schwann cell-occupied regions of the CSTs. This probably relates to the presence of fibroblasts in the injected cultures. These studies demonstrate that long-projecting axons of the spinal cord are capable of interacting with Schwann cells, irrespective of the mechanism by which these cells gain access to the central nervous system.     

软骨的低温保存/移植研究进展

低温保存是实现软骨长期贮存、建立组织库的必要手段。我们回顾了过去10年来在软骨的低温保存和保存后移植方面的进展情况,指出现有的保存技术仍不成熟,需要更加系统和深入的研究。     

Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?

OBJECTIVES:

This study compared the accuracy of the Simplified Acute Physiology Score 3 with that of Acute Physiology and Chronic Health Evaluation II at predicting hospital mortality in patients from a transplant intensive care unit.

METHOD:

A total of 501 patients were enrolled in the study (152 liver transplants, 271 kidney transplants, 54 lung transplants, 24 kidney-pancreas transplants) between May 2006 and January 2007. The Simplified Acute Physiology Score 3 was calculated using the global equation (customized for South America) and the Acute Physiology and Chronic Health Evaluation II score; the scores were calculated within 24 hours of admission. A receiver-operating characteristic curve was generated, and the area under the receiver-operating characteristic curve was calculated to identify the patients at the greatest risk of death according to Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores. The Hosmer-Lemeshow goodness-of-fit test was used for statistically significant results and indicated a difference in performance over deciles. The standardized mortality ratio was used to estimate the overall model performance.

RESULTS:

The ability of both scores to predict hospital mortality was poor in the liver and renal transplant groups and average in the lung transplant group (area under the receiver-operating characteristic curve = 0.696 for Simplified Acute Physiology Score 3 and 0.670 for Acute Physiology and Chronic Health Evaluation II). The calibration of both scores was poor, even after customizing the Simplified Acute Physiology Score 3 score for South America.

CONCLUSIONS:

The low predictive accuracy of the Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores does not warrant the use of these scores in critically ill transplant patients.