Paired kidney analysis of tacrolimus and cyclosporine microemulsion-based therapy in Chinese cadaveric renal transplant recipients

Few studies used paired kidneys for comparison between tacrolimus and cyclosporine in renal transplantation. Most of the published data used whole blood trough levels for drug monitoring. However, the use of limited sampling strategy and abbreviated formula to estimate the 12-h area under concentration-time curve (AUC(0-12)) allowed better prediction of drug exposure. Sixty-six first cadaveric renal transplant recipients receiving paired kidneys were randomized to receive either tacrolimus-based (n = 33) or cyclosporine microemulsion (Neoral)-based therapies (n = 33). Abbreviated AUC(0-12) was used for drug monitoring and dose titration. Mean follow-up duration was 2.8 +/- 2 years. The patient and graft survival were comparable. Fewer incidence of acute rejection was observed in tacrolimus group (15% vs. 27.3%) though the difference was not significant (P = 0.23). The absolute value and the rate of decline of creatinine clearance were both significantly better in tacrolimus-treated patients. Prevalence of hypertension, post-transplant diabetes mellitus, infection, and malignancy were similar in both groups. Prevalence of hypercholesterolemia (11/33 vs. 4/33) and gum hypertrophy (6/33 vs. 1/33) was more common in cyclosporine-treated patients (P = 0.04 in both parameters). This was the first prospective, randomized study with paired kidney analysis showing the renal function was significantly better in tacrolimus-treated patients than in cyclosporine-treated patients.     

Agilent 2100 Bioanalyzer在人乳头瘤病毒检测中的应用

目的：探讨Agilent2100Bioanalyzer芯片分析系统（简称Bioanalyzer)在人乳头瘤病毒（HPV）的PCR检测和分组中的应用。方法：先分别进行通用引物介导PCR（GP－PCR）和型特异性引物介导PCR，扩增HPV高保守区（L1区）的共同序列和各型（包括HPV6，11，16和18型）的特型性序列，然后分别用常规的琼脂糖凝胶电泳技术和Bioanalyzer对PCR产物进行检测，并比较两种检测方法的准确度，重复性和灵敏度。结果：Bioanalyzer在确定片段长度时的准确度和重复性比琼脂糖凝胶电泳高，前者的准确度在95％以上，后者仅为85％，Bioanalyzer的检测灵敏度比琼脂糖凝胶电泳高100倍，结论：Bioanalyzer芯片分析系统结合PCR方法可对HPV进行特异，准确，稳定，灵敏的检测和型别鉴定，具有重要的推广价值。     

数字减影子宫输卵管造影术

目的:介绍和评价数字减影与自动高压注射器联合应用于子宫输卵管造影(HSG)。方法:自行设计造影用硅胶管使之能与自动高压注射器相联接,用40%泛影葡胺和数字减影方法作造影;随机抽取常规透视点片碘油造影片44份,数字减影泛影葡胺造影片50份进行对照分析。结果:两组比较:清晰度宫腔无显著性差异(P>0.05),输卵管有显著性差异(P<0.05);输卵管通畅率、血管或(和)淋巴管回流率有显著性差异(P<0.05)。盆腔涂布无显著性差异(P>0.05)。结论:采用数字减影与高压注射器行子宫输卵管造影能提高造影质量。     

米非司酮对妊娠中期胎儿心脏超微结构的影响

目的:探讨米非司酮对妊娠中期胎儿心脏超微结构的影响。方法:将计划引产孕妇随机分为两组:对照组(水囊组)10例,实验组(米非司酮+水囊)15例。实验组按孕龄分为实验Ⅰ组(10例,16~22周),实验Ⅱ组(5例,23~28周)。实验组口服米非司酮100mg,连服3天,行水囊引产,对照组只行水囊引产。胎儿娩出后取心肌组织进行样本制备,然后在电镜下观察组织的超微结构。结果:细胞肿胀、空化,细胞膜不完整,闰盘分离,部分细胞连接消失。细胞核多呈不规则形,核内染色质凝聚呈块状,部分细胞核空化,核周围可见脂褐素。大部分肌丝断裂,肌节结构消失,少数可辩残留肌节结构,其间可见少量核糖体,但各带结构不清。线粒体肿胀,高度空化,嵴断裂,细胞基质局部空化。毛细血管内皮细胞肿胀。心肌组织细胞的超微结构有改变,且孕龄越小,超微结构改变越明显。结论:米非司酮可以引发胎儿心脏的缺血缺氧性改变。     

经股动脉导管药盒系统植入术的并发症分析

目的研究经股动脉途径植入导管药盒系统导致并发症的原因,进一步提高其临床应用的价值。方法对76例中晚期恶性肿瘤采用经股动脉途径植入导管药盒系统,定期或不定期经皮经药盒灌注化疗和栓塞,总结其并发症。结果发生并发症13例,发生率为17.1%(13/76)。包括留置导管尖端移位4例,靶动脉闭塞2例,迟发出血2例,留置导管堵塞1例,切口延期愈合1例,药盒外露1例,留置导管与药盒分离1例,靶动脉假性动脉瘤形成1例。结论经皮股动脉途径导管药盒系统植入术的并发症只要处理得当,是可以控制的。本技术不失为一种安全可靠的治疗手段,值得临床应用。     

经肝动脉As2O3碘化油化疗栓塞 对兔肝移植瘤生长及转移的影响

目的观察As2O3与碘油联合经肝动脉化疗栓塞术后对兔VX2肝移植瘤生长及转移的作用.方法 40只家兔肝内肿瘤种植后2周,随机分为5组,经肝动脉插管分别给予不同处理,实验设生理盐水灌注组、As2O3灌注组、单纯碘油栓塞组、阿霉素碘油栓塞及As2O3碘油栓塞组,As2O3的用量为2 mg/kg.肿瘤种植后5周,测量动物体重,所有动物均处死,取出肝脏及双肺标本,测定肝脏的重量,计算肝移植瘤的体积、坏死面积,观察肝内、双肺及其他器官肿瘤转移的发生率.结果肿瘤植入后5周,各处理组动物体重均有明显的下降,肝脏重量增加,计算的肝指数各组分别为9.8±2.2、9.7±2.1、8.5±2.0、8.4±2.1、6.4±1.2;肿瘤体积分别为(35.5±7.6) cm3、(32.2±9.7) cm3、(21.2±8.5) cm3、(20.9±11.3) cm3、(11.8±4.0) cm3,栓塞治疗组与非栓塞治疗组间差异有统计学意义,As2O3碘油栓塞治疗组与其他组相比差异有统计学意义.平均坏死率各组间差异无明显的统计学意义.双肺转移结节的数目各组分别为52.4±32.2、51.8±26.3、54.8±29.2、53.5±30.7、19.6±17.0;转移结节的直径各组分别为(3.8±1.2) mm、(3.6±1.1) mm、(3.9±1.3) mm、(3.5±1.6) mm、(2.2±0.7) mm.As2O3碘油栓塞治疗组与其他各组相比差异有统计学意义(P<0.05).结论 As2O3与碘油联合经肝动脉栓塞治疗,可抑制肝移植瘤的生长及肺转移.     

肾病综合征患者腺苷脱氨酶活性的变化及意义

通过检测对激素不同反应、不同病情的肾病综合征（NS）患者的血清及淋巴细胞内腺苷脱氨酶（ADA）的活性变化，观察ADA活性与临床疗效的关系。     

Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory.

AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median [IQR: Q1-Q3] fluoroscopy time and dosage was observed: 21.2 [12.1-33.8] min, 1110 [395-3234] microGym2 (group I); 6.5 [4.4-15.4] min, 290 [129-489] microGym2 (group II), and 4.9 [3.4-8.0] min, 129 [74-270] microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number [Q1-Q3] of radiofrequency current applications in groups I, II, and III was 4 [2-9], 4 [2-6], and 2 [2-4], respectively. No complications occurred. CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure.     

红景天对高原去势大鼠骨质疏松症的血清IL-6、TNF-α和尿DPD影响

目的:探讨高原高寒地区低氧环境去势大鼠骨质疏松症与血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和尿脱氧吡啶酚(DPD)的关系及红景天预防骨质疏松的作用。方法:选用Wistar雌性大白鼠75只,分别摘除卵巢或假性去卵巢。分为A组(假手术组),B组(切除卵巢组),C组(切除卵巢 尼尔雌醇组),D组(切除卵巢 红景天混合饲料组),E组(切除卵巢 红景天浸液组)。每组15只,术后在海拔3100m青海海北州地区饲养,术后3个月处死,应用放免方法测定血清IL-6、TNF-α和化学发光法测定尿中DPD含量。结果:B组血清IL-6、TNF-α和尿DPD含量显著高于A、C、D、E组。C、D、E组血清IL-6、TNF-α和尿DPD含量与A组比较差异无显著性统计学意义。结论:红景天的抗高原骨质疏松症的作用可能与降低血清IL-6、TNF-α含量和尿中DPD浓度有关。     

Triptolide inhibits T cell activation and proliferation via multiple pathways

Triptolide is potent immunosuppressive has been reported to inhibit autoimmunity, compound isolated from Chinese herbal medicine. Triptolide allograft attributed to the suppression of T cells via NF - kB rejection and GVHD, and its efficacy was previously pathway and apoptosis. In the present study, we detailedly analyzed Triptolide＇ s function on murine primary T cell. We found that Triptolide could inhibit T cell activation and proliferation by dramatically down - regulating cell division and cell cycle. Triptolide inhibited T cell activation in a dose- dependent manner, and the inhibition was mediated by both NF- kB pathway and AP - 1 pathway.