An economic analysis of pancreas transplantation: costs, insurance coverage, and reimbursement

Since 1988 the demand for the pancreas transplantation has continued to increase. This has been accompanied by a growth in the number of centers offering the procedure, and an increase in the number of transplants performed. The National Cooperative Transplantation Study was undertaken to document the costs of all transplants, including pancreas transplantation. Data on transplantation procedure charges, from date of transplant to discharge, were obtained from 66.7% of all pancreas transplantation programs active in 1988. These programs accounted for 72% of all transplants performed that year. Valid sample survey data (no more than 25 transplants per center) were obtained for 133 randomly selected patients. This constituted 54% of all procedures done in the United States in 1988. Detailed data were also collected on sources of payment and amount reimbursed. Due to outlier data, we report statistical medians, rather than means, as our measure of central tendency. The median charge for a pancreas transplant with or without a kidney was $66917, with a hospital length of stay of 21 days, compared with a kidney transplant alone at $39625 and a hospital length of stay of 14 days. Total pancreas transplant charges fell between $45260 and $105375 for 50% of the cases studied. Half of the patients had a hospital length of stay between 16 and 33. Due to the small number of cases available for analysis, it was not meaningful to cross-classify the data according to various prognostic variables.(ABSTRACT TRUNCATED AT 250 WORDS)     

小鼠补体受体Ⅱ型基因改造后感染EB病毒

通过对小鼠补体受体Ⅱ型基因（CR2）进行定点突变,然后将野生型和突变型小鼠CR2/1（MCR2/1）及人CR2（hCR2)用电穿孔方法导入小鼠SP2/0进行表达,采用免疫组织化学等方法鉴定阳性细胞系。用EB病毒对转染阳性细胞进行感染,EBER-1杂交结果显示,仅转染hCR2和突变型MCR2（mtMCR2)的SP2/0细胞感染了EB病毒,前者感染EB病毒的阳性率较后者高很多。这为进一步研究EB病毒进入细胞的机制及建立EB病毒相关的鼻咽癌动物模型奠定了良好的基础。     

海水淹溺肺水肿兔血浆MDA和SOD的变化

目的 :观察海水淹溺肺水肿 (PE SWD)兔血浆中丙二醛 (MDA)和超氧化物歧化酶 (SOD)变化规律 ,探讨上述两项指标发生变化的原因和机制。方法 :用核黄素光照法和硫代巴比妥酸法 ,对PE SWD兔动脉血浆MDA和SOD进行定量检测和动态观察。结果 :灌海水后 30min ,MDA和SOD较灌海水前均显著升高 ,尔后两者均逐渐下降 ,但仍远远高于灌海水前。结论 :PE SWD发生发展过程中 ,MDA的损害性作用使肺泡表面活性物质表面特性发生改变 ,影响了正常的呼吸功能 ,并掩盖了SOD的保护性作用。     

假鹰爪化学成分研究(Ⅱ)

目的：寻找番荔枝科假鹰爪属植物假鹰爪Ｄｅｓｍｏｓ ｃｈｉｎｅｎｓｉｓ抗肿瘤活性成分。方法：采用硅胶柱色谱分离化学成分。根据理化性质及波谱分析等方法鉴定结构。结果：从氯仿萃取物中分离鉴定了７个化合物,分别是ｕｎｏｎ－ａｌ（Ⅰ）,黄芩素－７－甲醚（Ⅱ）,去甲氧杜鹃花素（Ⅲ）,去甲氧杜鹃花素－７－甲醚（Ⅳ）,苯甲酸（Ⅴ）,β－谷甾醇（Ⅵ）和豆甾醇（Ⅶ）。结论：该种植中鉴定的黄酮类化合物均为β－环未取代,     

The role of mtDNA deletion in the sensitivity to aminoglycoside antibiotic induced deafness]

OBJECTIVE: To establish an animal model of mitochondrial DNA (mtDNA) deletion and investigate the possible role of mtDNA deletion in aminoglycoside antibiotic induced deafness. METHODS: Thirty wistar rats (4 months) were randomly divided into group A and B. Doxorubicin (DOX) was subcutaneously injected at doses of 2 mg/kg twice per week for 3 months in group A and then kanamycin (KM) was intraperitoneally injected 500 mg/kg per day for 10 consecutive days. The treatments of group B were identical to group A, except normal saline was substituted for DOX. The thresholds of auditory brainstem response (ABR) were measured before and after the drug administrations. The inner ear membranous labyrinthine tissue was harvested and mtDNA was amplified to identify 4,834 bp deletion by PCR technique. RESULTS: The elevation of the mean ABR thresholds in group A(67.08 +/- 8.59) dB peSPL was significantly higher than that in group B (12.71 +/- 4.42) dB peSPL after KM administration (P < 0.001). In group A, 9 of the 15 rats demonstrated 4,834 bp mtDNA deletion. However, mtDNA 4,834 bp deletion was negative in group B animals. CONCLUSION: DOX can induce mtDNA deletion in the inner ear tissue of the rat. mtDNA deletion in the inner ear may play an important role in the hypersensitivity to aminoglycoside antibiotic ototoxicity.     

普萘洛尔(心得安)对灰鼠噪声性聋的影响

目的 研究噪声和β受体阻滞剂普萘洛尔（心得安）对灰鼠耳蜗复合动作电位和耳蜗血流的影响。方法 使用１／２倍频程窄带、噪声其中心频率１５００ＨＺ,强度１１５ｄＢＳＰＬ,持续刺激９０分钟。观察不同浓度普洛尔对灰鼠耳蜗复合动作电位和耳蜗充的影响结果     

EFFECT OF VL AND VH CONSENSUS SEQUENCE-SPECIFIC PRIMERS ON THE BINDING AND EXPRESSION OF A MINI- MOLECULE ANTIBODY DIRECTED TOWARDS HUMAN GASTRIC CANCER

Objective. To construct ScFv and Fab from murine anti-gastric cancer monoclonal antibody(mAb) 3H11.Methods. At first,3H11 ScFv and Fab were constructed with Ⅴ genes PCR amplified by degenerate primers for FR1 .The bacterial expressed 3H11 Ab fragments showed no antigen binding activity.Then,phage antibody library and random mutated library were constructed from 3H11 hybfidoma cells and panning selection was performed. Again the i-dentification of positive clone was failed. Finally the N-terminal sequences of Ⅴ regions were resumed to 3H11 original sequences by site-directed mutagenesis via PCR.Restdts. Binding activity to gastric cancer cells was detected only from N-terminal sequence corrected 3H11 ScFv and Fab, though the expression of the Ab fragments was not affected. Correction of either VL or VH N-terminal se-quences could partially resume the antigen binding activity. Conclusion. Sequence changes of Ⅴ region N terminal introduced by PCR may seriously affect antigen binding without affecting the expression of antibody.     

Simultaneous Construct Surface Microstructural and Internal Network-Like Conductive Pathways of Poly(l-lactic acid)/Carbon Nanomaterials Composite Foams

The poly(l -lactic acid) (PLLA)/carbon nanomaterials composite foams with hierarchical surface microstructural and internal conductive pathways are successfully prepared by a simple crystallization-assisted rapid phase separation (CARPS). The dimension and morphology of carbon nanomaterials can induce different crystallization forms to construct the hierarchical surface microstructure, and they are distributed on the phase interface of solvent and non-solvent to form conductive pathways. It is found that the heterogeneous nucleation of nanomaterials promotes a significant increase in crystallinity, and a stacked granular structure formed on the surface promotes the increase of the water contact angle to 148.7°. Foams with interconnecting pore structures contribute to the formation of 85.3% porosity and 12.33 g g⁻¹ oil absorption. Carbon nanomaterials are distributed on the pore walls of the porous foam, which converts the foam from an insulating material to a conducting polymer. Furthermore, the uniform distribution of nanomaterials significantly affects the thermal stability of the PLLA. In belief, the multifunctional biodegradable foam, prepared by a CARPS method, makes it promising for industrial production and has potential applications in electrical conductivity, oil-water separation, and many other fields.     

Disease type-associated increases of the plasma levels and ligand expression for natural alpha- or beta-galactoside-binding immunoglobulin G subfractions in patients with lung cancer

The presence of natural carbohydrate-binding antibodies may play a role in host defence against malignant cells in addition to elicitation of an immune response by artificial carbohydrate antigens. Human serum contains immunoglobulin G(2) (IgG) fractions with selectivity to alpha- and to beta-galactosides, respectively, irrespective of the type of blood group of the donor. To determine whether these naturally occurring subfractions may have any relevance for tumor disease control, their binding to malignant cells was ascertained by cytofluorimetric assays in vitro with a number of human tumor cell lines of different histogenetic origin. The affinity of cell binding was comparable to that of binding to lactosylated or melibiosylated neoglycoconjugates as model ligands in solid-phase assays and K-D values were found to be in the range of 5-300 nM. Cross-reactivity of the anomer-selective subfractions to the other type of ligand was observed to be rather low. When the IgG contents of plasma samples of patients with diverse types of lung cancer were assessed, the concentrations of both galactoside-binding immunoglobulin G subfractions were significantly increased in association with presence of small cell lung carcinoma and of metastatic lesions to the lung without any marked change in the overall IgG plasma level. Such an apparently general enhancement was seen for patients with adenocarcinoma and included both subfractions with no impact on their percentage in the total IEC content. When detergent extracts of tumor and tumor-free specimens of the same patient were analyzed with the affinity purified antibody subfractions to comparatively determine ligand presentation, increases in sugar-inhibitable binding were especially noted for the tumor tissue of small cell lung carcinomas and apparently tumor-free samples of cases with lung metastasis. Material from other types of lung cancer revealed no significant indication for disease-related alterations with the exception of carcinoids. These data demonstrate that plasma levels and ligand expression for two types of natural galactoside-binding immunoglobulin G fractions can show nonuniform responses in patients within the class of lung cancer. They encourage to deliberately monitor these parameters of the natural carbohydrate-directed antibody fractions in cancer patients with various types of disease to clarify the clinical significance of respective malignancy-associated changes.