Volume 86  ·   Issue 18  ·  2006

With the continuous improvement of surgical techniques and the development of new immunosuppressants, the effect of liver transplantation has been greatly improved, but biliary complications are still a common problem after liver transplantation, and it is one of the main causes of liver transplantation failure at present. Its incidence is as high as 5.8% ~24.5% [1]. Therefore, it is more and more important to correctly understand biliary complications and take effective countermeasures in clinical practice [2-5].

Objective to investigate the therapeutic effect of pravastatin and its mechanism of antioxidant damage in a rat model of acetic acid-induced colitis. Methods Sixty SD rats were randomly divided into normal control group (10 rats), model placebo group (20 rats), pravastatin treatment group (15 rats) and sulfasalazine (SASP) treatment group (15 rats). The normal group was kept routinely, and the model placebo group, pravastatin treatment group and SASP treatment group were treated with normal saline 2 ml/d, pravastatin 1 mg · kg-1 · d-1 and SASP 0.25 g · kg-1 · d-1 respectively after 8% acetic acid modeling for 7 days. The activity state, food intake, body weight, stool characteristics and stool bleeding of the rats were observed, and the disease activity index (DAI) was calculated to judge the efficacy. On the 8th day, the rats were sacrificed and the colon length, colon mucosal damage index (CMDI) score, histological grade, and the contents of nitric oxide (NO) free radical, lipid peroxidation product malondialdehyde (MDA) and superoxide dismutase (SOD) were measured In the treatment group, DAI, colon length, CMDI and histological grade were significantly improved (P<0.05), the contents of NO free radical and MDA were significantly decreased, and the contents of SOD were significantly increased (P<0.05). Conclusion Pravastatin can reduce colonic inflammation by inhibiting oxidative damage, and its curative effect is better than that of traditional medicine SASP.

Objective to investigate the therapeutic effects of rosiglitazone and metformin on non-alcoholic fatty liver disease (NAFLD) in rats. Methods 44 male SD rats were divided into normal control group (8 rats) and NAFLD group (36 rats). The rat model of NAFLD was established by feeding high-fat diet. At the end of 8 weeks, 4 rats in the NAFLD group were sacrificed. After confirming the success of modeling, the NAFLD group was further divided into 4 groups: NAFLD control group (8 rats), rosiglitazone treatment group (8 rats), metformin treatment group (8 rats) and diet treatment group (8 rats). Except for the NAFLD control group, all the other groups were fed normal diet. At the end of 12 weeks, all animals were sacrificed, and blood lipid, liver function, tumor necrosis factor α (TNF-α), liver lipid, liver tissue TNF-α, fatty acid synthase (FAS) mRNA expression and liver histopathology were measured. Results Blood triglycerides (0.61 mmol/L ± 0.17 mmol/L, 0.63 mmol/L ± 0.16 mmol/L vs 0.85 mmol/L ± 0.16 mmol/L) in the rosiglitazone and metformin treatment groups Hepatic function (alanine aminotransferase: 38.3 U/L ± 10.6 U/L, 43.3 U/L ± 27.5 U/L vs 110.6 U/L ± 44.2 U/L, aspartate aminotransferase: 141.7 U/L ± 14.3 U/L, 174.5 U/L ± 57.9 U/L vs 251.8 U/L ± 91.0 U/L), The contents of triglyceride in liver tissue (18.9 mg/g±2.7 mg/g,20.4 mg/g±3.6 mg/g vs 54.8 mg/g±7.6 mg/g) were significantly lower than those in NAFLD control group (all P<0.05), and the degree of hepatic steatosis (grades: 0.8 ± 0.3,1.0 ± 0.2 vs 2.8 ± 0.5) and inflammation (scores: 0.8 ± 0.2,1.0 ± 0.3 vs 1.8 ± 0.4) were also significantly reduced (all P<0.01). Diet treatment could also improve the dyslipidemia and liver histopathological changes to some extent, but the improvement of liver function abnormalities and liver inflammation was not obvious, and the curative effect was not as good as that of the two drug treatment groups. The expression levels (0.22±0.14, 0.29±0.16 vs 0.68±0.23) were also significantly lower than those of NAFLD control group (all P<0.05). Conclusion Rosiglitazone and metformin can effectively treat NAFLD in rats.

Objective to dynamically observe the effects of chronic mild to moderate iodine excess on thyroid oxidative damage and antioxidant capacity in iodine-deficient and non-iodine-deficient Wistar rats. Methods 4-week-old Wistar rats were fed with low iodine diet for 3 months. After replication of low iodine goiter model, they were randomly divided into 3 groups: low iodine control group (IDC), iodine supplementation group (IS Ⅰ) and iodine supplementation group (IS Ⅱ). Each group was fed with double distilled water, potassium iodate water containing iodine 100 μ g/L and 330 μ g/L, respectively. Another 4-week-old Wistar rats were fed with normal diet for 3 months. They were randomly divided into 3 groups: normal control group (NC), high iodine group (IE Ⅰ) and high iodine group (IE Ⅱ). Each group was fed with double distilled water, potassium iodate water containing iodine 300 μ g/L and 660 μ g/L, respectively. The rats were sacrificed at 1, 2, 4, 8 and 24 weeks after treatment factors. The activities of glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD), malondialdehyde (MDA) and hydrogen peroxide in the thyroid gland of rats were determined by biochemical method After iodine supplementation, the activity of thyroid GSH-PX in IS Ⅰ and IS Ⅱ groups showed a significant decrease trend, which was significantly lower than that in IDC group after 4 weeks and 2 weeks, respectively (P<0.001 or P<0.05), and GSH-PX was lower than that in NC group at 4 weeks and 24 weeks (P<0.001, P<0.01 or P<0.05). The activity of thyroid SOD in IS Ⅰ and IS Ⅱ groups also showed a gradual decrease trend, which was significantly lower than that in IDC group after 8 weeks (P<0.001 or P<0.05). Compared with NC group, the activity of thyroid GSH-PX in IE Ⅰ and IE Ⅱ groups decreased significantly at 24 weeks (P<0.01). Conclusion The degree of thyroid oxidative damage was reduced after supplementation of iodine at 100 μ g/L and 330 μ g/L in Wistar rats with iodine deficiency, but at the same time, the thyroid antioxidant defense ability was decreased.

Objective to investigate the mechanisms of P38, ERK, Rho and other signals during the differentiation of rat bone marrow mesenchymal stem cells (MSCs) into epidermal cells. Methods (1) MSCs were isolated and expanded by Ficoll-Paque lymphocyte isolate, and the surface markers were detected by immunocytochemistry and flow cytometry. (2) The expression of phosphorylated P38 and ERK in directed induction were divided into normal control group, simple induction group and Rho blockade group; (3) Effects of SB203580 and PD98059 on the induction of MSC into epidermoid cells: control group, simple induction group, p38 blocking group (SB203580 was added to the induction solution) and ERK blocking group (PD98059 was added to the induction solution). After 7 days of induction, the positive expression rates of cytokeratin CK5/8 and CK19 in each group were detected by immunocytochemistry and flow cytometry respectively. (4) Effects of Rho blocker HA1077 on CK5/8 and CK19: normal control group, simple induction group and Rho blocking group were set up. The cells cultured for 7 days were taken and the expression of CK5/8 and CK19 was detected by flow cytometry. Results (1) After the in vitro expansion of rat bone marrow MSC, the results of immunocytochemistry and flow cytometry showed that the expression of CD29 and CD44 was positive, while the expression of CD34 and CD45 was negative. (2) The normal level of phosphorylated p38 was 0.02% The control level of phosphorylated ERK was 4.23%, which decreased at 3 days (0.39%) and 5 days (0.40%) after induction, and returned to the pre-induction level at 7 days (5.10%). In Rho-blocked group, the phosphorylated P38 levels increased at 1, 3, 5 and 7 days, respectively, 1.11%, 71.19%, 0.25% and 6.86%; ERK phosphorylation was 6.17%, 4.13%, 3.97% and 0.41% at 1, 3, 5 and 7 days, respectively. (3) Effects of SB203580 and PD98059 on the induction of MSC into epidermoid cells: Flow cytometry showed that the positive rates of CK5/8 and CK19 were 3.01% and 6.47%, respectively, after 7 days of induction; The positive expression rates of CK5/8 and CK19 were 1.43% and 5.41% in p38-blocking group, respectively, lower than those in the induction group. The positive expression rates of CK5/8 and CK19 in ERK-blocking group were 5.54% and 7.56%, respectively. (4) Effect of HA1077 on CK5/8 and CK19: The positive rates of CK5/8 and CK19 in induction group alone were 1.81% and 10.19%; After adding HA1077, CK5/8 was 21.65% and CK19 was 39.41%, which increased significantly. Conclusion the P38 pathway may play a positive role in promoting the differentiation of MSC into epidermoid cells, and the blockade of upstream signal Rho may increase the activation of P38 pathway and promote the differentiation of MSC into epidermoid cells to some extent.

Objective to investigate the appropriate diagnostic criteria of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma. Methods 275 patients with newly treated nasopharyngeal carcinoma were examined by magnetic resonance (MRI). The longest and shortest axial diameters of retropharyngeal lymph nodes were measured before anti-tumor therapy. According to the MRI follow-up results, the lymph nodes were qualitatively evaluated. The operating characteristic curve (ROC curve) was analyzed to determine the appropriate axial diameters and boundary values for the diagnosis of retropharyngeal lymph node metastasis. Results 468 retropharyngeal lymph nodes were detected in 275 patients. After follow-up, 240 were positive and 228 were negative. The shortest axial diameters of positive and negative lymph nodes were 9.9 mm ± 4.8 mm and 3.3 mm ± 1.2 mm, respectively (P<0.01), while the longest axial diameters were 12.9 mm ± 5.8 mm and 5.7 mm ± 2.0 mm, respectively (P<0.01). Among the axial diameters, the shortest axial diameter ≥6mm was the most appropriate diagnostic criteria for retropharyngeal lymph node metastasis, with sensitivity 84.1%, specificity 94.3% and accuracy 89.1% Conclusion It is more scientific to use the shortest axial diameter ≥6 mm and central necrosis of lymph nodes as the diagnostic criteria of retropharyngeal lymph node metastasis of nasopharyngeal carcinoma.

Objective to determine whether there is occult injury in normal brain tissue (NABT) of relapsed transitional multiple sclerosis (RRMS) by using diffusion tensor imaging (DTI) histogram analysis, and to study the correlation between DTI histogram index of NABT and extended disability (EDSS) score, disease course, T2WI lesion volume and brain tissue volume.Methods 24 patients with RRMS and 24 normal volunteers with matched sex and age were examined by routine MRI and DTI. After segmentation and extraction of NABT, the mean diffusion rate (MD) and partial anisotropy (FA) histograms of NABT were obtained and analyzed. Results The mean MD of NABT was 1.014×10-3mm2·s-1, the peak position of MD histogram was 0.809×10-3mm2·s-1, and the peak height of FA histogram was 4.502‰ (0.910×10-3mm2·s-1, 0.767×10-3mm2·s-1 and 4.107‰, respectively) (P<0.001), while the peak height of MD histogram was 8.858 However, most of the indexes were significantly correlated with the volume of T2WI lesions and the volume of brain tissues. Conclusion There was occult injury in NABT in patients with RRMS, and the degree of injury was related to the burden of brain lesions and the degree of brain atrophy.

Objective to investigate the status of newly diagnosed abnormal glucose metabolism in Chinese patients with acute coronary syndrome, and to explore the correlation between abnormal glucose metabolism and traditional cardiovascular risk factors.Methods 1328 patients with acute coronary syndrome admitted to cardiac intensive care unit from June 1, 2005 to August 31, 2005 with no previous history of diabetes and admitted blood glucose<11.1 mmol/L were selected from 52 centers in 7 cities in China. The simplified oral glucose tolerance test (OGTT) was performed before discharge to understand the glucose metabolism of patients. Results Among the enrolled populations (n =1328), the proportion of hyperglycemia (including newly diagnosed diabetes mellitus and abnormal glucose regulation) was about 67%, and 287 cases met the diagnosis of diabetes mellitus, accounting for 22% of all enrolled cases, and 45% (601 cases) had abnormal glucose regulation. The differences of different glucose metabolism states in dyslipidemia, hypertension, body mass index, waist circumference and glycosylated hemoglobin were statistically significant (P<0.001). Multiple Logistic regression analysis showed that waist circumference and dyslipidemia were the relative risk factors in the newly diagnosed diabetic group (P<0.05). Conclusion Newly diagnosed abnormal glucose metabolism was very common in patients with acute coronary syndrome without diabetes history, and newly diagnosed abnormal glucose metabolism was closely related to waist circumference and dyslipidemia.

Objective to investigate the role of C-reactive protein (CRP) in evaluating the activity of Crohn's disease (CD). Methods Logistic regression was used to analyze serum CRP, ESR, clinical activity index (CDAI), endoscopic activity, histological activity, hypoalbuminemia and anemia in 81 patients with CD. The effects of clinical severity, lesion site and drug therapy on CRP were compared. Nuclear factor κ B p65 (NF-κ B p65) immunohistochemical staining in colonoscopic biopsy tissues. Results CRP was correlated with ESR; There was no correlation with CDAI, endoscopic activity, histological activity, hypoalbuminemia and anemia; CRP increased significantly in active CD (P<0.01), and increased significantly in severe and colonic CD (P<0.05). CRP decreased significantly when the drug effectively controlled the disease (P<0.01), and increased again when the disease recurred (P>0.05); The expression of NF-κ B p65 in CD was enhanced (P<0.01), which was consistent with the increase of serum CRP (P =1.0). Conclusion The increase of CRP is more suitable for reflecting the activity of moderate and severe colonic CD; Rapidly reflect the effectiveness of drug treatment; The increase of serum CRP is consistent with the enhancement of NF-κ BP65 expression, which is worthy of further study.

Objective to investigate the integration of hepatitis B virus (HBV) on hepatocyte chromosome and its role in the formation of hepatocellular carcinoma. Methods Tissue DNA was extracted from 40 hepatitis B-related hepatocellular carcinoma specimens by protease digestion/phenol extraction method. HBV X gene and its flanking human genomic DNA fragments were amplified by polymerase chain reaction (PCR) using liver cancer tissue DNA as template, HBV X gene upstream sequence and human genome Alu repeat sequence as primers. The PCR products were tapped and recovered, and then automatically sequenced by ABI 3700 sequencer. The results were searched by NCBI (national center for biotechnology information) BLAST and MapViewer to determine the exact position of HBV integration on the chromosome. Results HBV integration occurred in 34 cases (85%) of 40 hepatitis B surface antigen-positive hepatoma tissues. The number of viral integration copies in each sample ranged from 1 to 5, so a total of 68 viral integration sites were obtained. From the analysis of viral genes, the integration can occur in any length of X gene, not concentrated in the commonly thought HBV DR1 and DR2 regions, but in 96% (65/68) of the integration, X gene was inserted into host cell DNA in a truncated form; From the analysis of host genes, HBV prefers to be inserted into introns and upstream regulatory regions of genes, but no insertion in exons is found. 80% of these genes have been reported to be related to tumors, and most of their products are closely related to basic cell survival and death, and can promote tumorigenesis in various cellular regulatory links. It is very significant that there are 3 genes out of 26 genes (myeloid/lymphoid or mixed-lineage leukemia 4, Gprotein alpha transducing activity polypeptide 1 and fibronectin 1) Conclusion the integration of HBV on the chromosome of hepatocellular carcinoma cells is not evenly distributed, and the "insertion mutagenesis" of the virus to host cells and the persistent expression of "truncated X protein" in the integron may play an important role in the carcinogenesis of the virus.

Objective to investigate the effect of brain death on the liver of Bama minipig and its mechanism.Methods Fifteen Bama minipig were randomly divided into brain death group (Group B), breviscapine treatment group (Group P) and control group (Group C), with 5 in each group.The brain death model was established by intracranial compression method.After successful modeling, no other treatment was performed in group B; In group P, breviscapine at 2.5 mg/kg was added to 100 ml of normal saline at 1 and 12 h after the initial confirmation of brain death, respectively, and intravenously infused; The levels of alanine transferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor α (TNF-α), IL-1 β and IL-6 were measured in serum at 3, 6, 12, 18 and 24 hours after brain death. HE staining was performed in liver tissues at 6, 12 and 24 hours after brain death, and the expression level of protein kinase C-α (PKC-α) was measured by immunohistochemistry, and the changes of PKC-α mRNA were measured by RT-PCR, and the changes of liver ultrastructure were observed at 12 and 24 hours after brain death. Results The ALT levels were 33.0±6.7, 29.0±1.6 and (36.6±5.6) U/L in group C, 141.8±9.1, 191.4±10.9 and (238.6±10.4) U/L in group B, and 91.0±4.9, 131.6±6.4 and (175.6±7.0) U/L in group P, respectively. AST levels in group C were 27.4±3.9, 29.8±1.6 and (29.2±3.4) U/L, respectively; Group B was 91.4±8.1, 126.6±5.5 and (184.4±5.4) U/L, respectively; Group 59.2±6.1, 86.8±5.5 and (146.2±6.4) U/L, respectively; The serum ALT and AST levels in group B increased gradually with the prolongation of brain death time; The levels of IL-1 β of inflammatory mediators at 3, 6, 12, 18 and 24 h after the first determination of brain death were 5.91±0.17, 5.91±0.10, 6.06±0.12, 6.08±0.12 and (6.10±0.15) pg/ml in group C, 8.26±0.21, 9.17±0.08, 10.30±0.11, 12.53±0.35 and (16.37±0.16) pg/ml in group B, and 7.75±0.12, 8.08±0.11, 9.25±0.21, 11.44±0.19 and (15.43±0.36) pg/ml in group P, respectively. The levels of IL-6 were 17.35±0.59, 18.04±0.23, 17.99±0.83, 17.77±1.05 and (17.62±0.67) pg/ml in group C, 29.50±1.92, 37.92±1.69, 46.32±1.70, 56.62±1.95 and (66.68±2.11) pg/ml in group B, and 21.27±1.05, 23.65±1.09, 31.46±1.91, 37.60±1.75 and 45.16±1.9 pg/ml in group P, respectively; The levels of TNF-α were 14.94±0.36, 15.03±0.49, 14.71±0.46, 14.66±0.31 and (14.64±0.63) pg/ml in group C, 19.45±0.16, 21.76±0.25, 24.31±0.20, 27.65±0.27 and (31.35±0.16) pg/ml in group B, and 18.45±0.11, 20.21±0.41, 23.41±0.32, 26.17±0.21 and (28.36±0.20) pg/ml in group P, respectively; The serum levels of IL-1 β, IL-6 and TNF-α in group B increased gradually with the prolongation of brain death time; The expression levels of PKC-α protein in hepatocytes at 6, 12 and 24 h were 0.0887±0.0113, 0.0950±0.0284 and 0.0994±0.0113 in group C, 0.1508±0.0108, 0.3811±0.0382 and 0.6209±0.0312 in group B, 0.1091±0.0292, 0.1284±0.0142 and 0.2995±0.0276 in group P, respectively. The expression levels of PKC-α protein in hepatocytes at 6, 12 and 24 h were 5782±594, 5501±423 and 5729±533 in group C, 26789±3059, 32877±5526 and 39869±6548 in group B, 24027±5012, 20409±4793 and 14307±3786 in group P, respectively. PKC-α may be involved in this injury mechanism. Breviscapine can inhibit the activation of PKC-α in animal liver, and breviscapine treatment can alleviate this injury of liver.

Objective to investigate the effects of preoperative or intraoperative splenectomy on liver transplantation patients. Methods The clinical data of 29 patients who underwent splenectomy were reviewed in the First Affiliated Hospital of Zhejiang University School of Medicine from February 1999 to May 2005. The patients were divided into preoperative splenectomy group (23 cases) and intraoperative splenectomy group (6 cases), respectively, and compared with 58 randomly selected liver transplantation patients without splenectomy in the same period, respectively, in terms of operation time, bleeding, blood transfusion, infection, acute rejection, survival rate and postoperative platelet recovery, etc. Results Compared with the non-splenectomy group, the preoperative splenectomy group and intraoperative splenectomy group took significantly longer operation time, intraoperative and postoperative blood transfusion increased significantly, and the bacterial infection rate increased significantly. The incidence of acute rejection after splenectomy did not decrease significantly. The cumulative survival rate of intraoperative splenectomy group was significantly lower than that of non-splenectomy group (P =0.0001). The mean platelet level of each group returned to normal on the 14th day after operation, Conclusion Splenectomy before or during liver transplantation is not beneficial to patients with liver transplantation, and the indications of splenectomy should be strictly grasped.

Objective to investigate the causes and preventive measures of ischemic biliary lesions (ITBL) after orthotopic liver transplantation. Methods the clinical data of 212 patients with orthotopic liver transplantation from February 1999 to August 2004 were retrospectively studied. The incidences of ITBL after orthotopic liver transplantation were 9.8% (10/102), 22.2% (2/9), 40% (2/5) and 14.6% (7/48). 14 patients were treated with conservative medical treatment, endoscopic treatment, surgical treatment and retransplantation. 7 cases were cured, 4 cases were improved, 1 case was ineffective and 1 case died. The effective rate of treatment was 78.6% (11/14), the cure rate was 50% (7/14), and the mortality rate related to ITBL was 7.1% (1/14). Timely treatment of postoperative hepatic artery lesions is an effective measure to prevent ITBL after orthotopic liver transplantation, and choosing appropriate treatment methods according to the lesions of bile duct tree is the key to obtain good curative effect in patients with ITBL after orthotopic liver transplantation.

Objective to analyze the clinicopathological factors affecting the prognosis of liver transplantation for liver cancer and summarize the clinical diagnosis and treatment experience.Methods the clinicopathological characteristics of 198 patients with liver transplantation for liver cancer were compared with the survival rate and the tumor-free survival rate (univariate analysis), and the independent prognostic indexes were obtained by Cox multivariate analysis. Results the 0.5-year, 1-year and 2-year survival rates of 198 patients with liver transplantation for liver cancer were 89%, 78% and 65%, and the tumor-free survival rates were 85%, 73% and 67%. The univariate analysis showed that the tumor size, the degree of tumor vascular invasion, pathological Edmondson grade, TNM stage and preoperative alpha-fetoprotein (AFP) affected the tumor-free survival rate, and the first four factors were related to the survival rate of patients.

Objective to evaluate the effect of different indication criteria on the prognosis of liver transplantation for liver cancer and to establish a new indication standard for liver transplantation for liver cancer suitable for China.Methods 251 cases of hepatocellular carcinoma liver transplantation in our hospital from April 2001 to January 2006 were retrospectively analyzed. The Kaplan-Meier method was used to statistically analyze the influence of different inclusion criteria on the survival rate and tumor-free survival rate after liver transplantation for liver cancer, and the differences between groups were tested by LogRank. Results The survival rates of 93 cases after 1, 2 and 3 years after Milan standard were 86%, 77% and 77%, and the tumor-free survival rates were 91%, 86% and 86%. The survival rates were 90%, 83%, 83% and 92%, 89%, 89% in 131 patients with California standard surgery. The 1, 2, 3-year survival rates of 207 patients were 84%, 74%, 67%, and tumor-free survival rates were 85%, 83%, 73%. However, the 1, 2, 3-year survival rates and tumor-free survival rates of 44 patients exceeding Pittsburgh criteria were significantly reduced (65%, 43%, 43% and 47%, 43%, 43%). When the indication was expanded to: single tumor diameter ≤9 cm; Or multiple tumors ≤3, with maximum tumor diameter ≤5 cm, total tumor diameter ≤9 cm, without macrovascular invasion, lymph node metastasis and extrahepatic metastasis (i.e. "Shanghai Fudan Standard"), the 1, 2, 3-year survival rate and tumor-free survival rate (88%, 80%, 90%, 88%, 88%) were not statistically significant compared with the strictest Milan standard, but the number of selected cases increased significantly to 151. Conclusion "Shanghai Fudan Standard" expands the scope of indications for liver transplantation of liver cancer, but does not reduce the overall postoperative survival rate and tumor-free survival rate, which may be more in line with the national conditions of China than Milan standard.

Vitamin D is important for bone growth and can prevent several cancers, especially rectal cancer, when used in appropriate doses, but when used in large doses to exploit its anticancer properties, it can cause excess calcium in the blood and cause toxic effects. Now, a study completed by the Lombardi Comprehensive Cancer Center of Georgetown University has shown that it is possible to separate the anticancer properties of vitamin D from other functions.

essential tremor (ET) is one of the most common motor disorders, including 4-12Hz postural and motor tremor of arms, head, lower limbs and voice. The prevalence of ET can reach 5% in the elderly over 65 years old, and the amplitude of tremor and corresponding dysfunction increase with age. The main drugs for the treatment of ET are propranolol and primidone. However, due to the side effects of drugs, the clinical application of both drugs is limited. In recent years, small sample studies suggest that topiramate (an anti-epileptic drug) can reduce tremor. Experts led by Dr. G. Ondo conducted a multicenter double-blind placebo-controlled parallel design clinical trial, the results of which were published recently<J Neurology, 2006, 66:672-677.

In 1993, it was discovered that adrenomedullin (AM) has antihypertensive effects, natriuretic and diuretic effects [1]. For AM receptors, McLatchie et al. [2] have reported new receptor consortia, including calcitonin receptor-like receptor (CRLR) and receptor activity modified protein (RAMP). RAMP1/CRLR consortia become specific receptors for calcitonin gene-related peptides; RAMP2/CRLR and RAMP3/CRLR consortia become AM-specific receptors [3]. Totsune et al. [4] reported that the expression of AM, RAMP2 and CRLR genes is upregulated in the heart of congestive heart failure rats. Therefore, the upregulation of AM receptor consortium components is carried out in different pathological states [5]. However, the characteristics of AM receptors that lead to LVH in hypertension are not fully understood.

Pure erythrocyte aplasia (PRCA) or delayed erythrocyte implantation is one of the complications of ABO blood group incompatibility, especially allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively analyzed the clinical data of 10 cases of PRCA after allo-HSCT in our hospital from August 1991 to March 2005 to explore the risk factors, clinical characteristics and treatment of PRCA.