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Three-dimensional (3D) printing has attracted more attention in food industry because of its potential advantages, including the ability to create customized products according to individual's sensory or nutritional requirements. However, the production of high-quality 3D printed foods requires the availability of edible bio-inks with the required physicochemical and sensory attributes. Starch, as one of the important sources of dietary energy, is widely used in food processing and is considered as one kind of versatile polymers. It is not only because starch has low prices and abundant sources, but also because desirable modified starch can be obtained by altering its physicochemical properties through physical, chemical and enzymatic methods. This article focuses on the utilization of starch as materials to create food-grade bio-inks. Initially, several kinds of commonly used 3D printers are discussed. The factors affecting the printing quality of starch-based materials and improvement methods are then reviewed, as well as areas where future researches are required. The applications of 3D printed starch-based materials in food industry are also introduced. Overall, starch appears to be one kind of useful substances for creating edible bio-inks that can be utilized within 3D food printing applications to create a wide variety of food products.

Formation and investigation of zein/carboxymethyl cellulose composite nanoparticles to co-deliver quercetin and resveratrol.

Nanotechnology is being used to create innovative food packaging systems that can inhibit the oxidation of foods, thereby improving their quality, safety, and shelf life. These nano-enabled antioxidant packaging materials may therefore increase the healthiness and sustainability of the food supply chain. Recent progress in the application of nanotechnology to create antioxidant packaging materials is reviewed in this paper. The utilization of nanoparticles, nanofibers, nanocrystals, and nanoemulsions to incorporate antioxidants into these packaging materials is highlighted. The application of nano-enabled antioxidant packaging materials to preserve meat, seafood, fruit, vegetable, and other foods is then discussed. Finally, future directions and challenges in the development of this kind of active packaging material are highlighted to stimulate new areas of future research. Nanotechnology has already been used to create antioxidant packaging materials that inhibit oxidative deterioration reactions in foods, thereby prolonging their shelf life and reducing food waste. However, the safety, cost, efficacy, and scale-up of this technology still needs to be established before it will be commercially viable for many applications.

Objective Cervical cancer is a common gynecologic cancer, and no study has been reported on the way through which lncRNA SNHG1, miR-195 and NEK2 jointly affect cervical cancer cells (CCCs), so this paper will explore a new approach to the development of cervical cancer in this respect. Methods Altogether 72 cervical cancer tissues and 54 adjacent tissues were collected. qPCR was performed to quantify lncRNA SNHG1 and miR-195, whose expression vectors were constructed and then transfected into CCCs, so as to observe their effects on the cells. Western blotting (WB) was carried out to detect protein levels. MTT assay was conducted to detect cell activity. Flow cytometry was performed to detect cell apoptosis. Transwell was carried out to detect cell invasion and migration. Results The expression of lncRNA SNHG1 up-regulated while that of miR-195 down-regulated in CCCs. lncRNA SNHG1 regulated NEK2 through its targeted binding to miR-195. The down-regulation of lncRNA SNHG1 or the up-regulation of miR-195 led to the decrease of NEK2 and the reduction of cells' activity, migration and invasion, also resulting in the increase of cell apoptosis. Rescue experiments showed that the down-regulation of miR-195 could offset the cell changes caused by lncRNA SNHG1. Conclusion lncRNA SNHG1 promotes the progression of cervical cancer through the miR-195/NEK2 axis, so lncRNA SNHG1, miR-195 and NEK2 may have potential values for diagnosing and treating cervical cancer.

Objective. To investigate the application and effect of the nurse-led “outpatient-ward-home” management model in the care of patients with chronic kidney disease (CKD). Methods. 120 patients with CKD admitted to our hospital between April 2020 and April 2021 were selected as trial subjects. All patients were divided into experimental and control groups according to the random number table method, with 60 cases in each group. The patients in the experimental group implemented the nurse-led “outpatient-ward-home” management model; the patients in the control group were given routine care and telephone follow-up. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), Pittsburgh Sleep Quality Index (PSQI) score, self-management scores, nutritional status, renal function indicators, and chronic renal failure quality of life scale (QLICD-CRF2.0) were compared between the two groups before and 6 months after the intervention. Results. Before the intervention, there were no statistically significant differences between the control and experimental groups in SAS, SDS, PSQI scores, self-management scores, QLICD-CRF2.0 scores, body mass index (BMI), prealbumin (PAb), albumin (ALB), serum creatinine (Scr), blood urea nitrogen (BUN), and glomerular filtration rate (GFR) levels ( P > 0.05 ). After 6 months of intervention, SAS, SDS, PSQI scores, Scr, BUN, and GFR levels were lower in the experimental group than in the control group; self-management scores, QLICD-CRF2.0 scores, BMI, PAb, and ALB levels were higher in the experimental group than in the control group ( P < 0.05 ). Conclusion. The nurse-led “outpatient-ward-family” intervention model can improve the negative emotions and sleep disorders of CKD patients, enhance patients’ self-management ability, and to a certain extent, slow down the disease process and improve the quality of life.

Purpose This study is aimed to investigate the specific regulatory role of S100 calcium binding protein A11 (S100A11) on cervical cancer (CC), and reveal the potential mechanisms relating to Wnt/β-catenin signaling. Patients and methods The expression of S100A11 in cervical squamous cell carcinoma (CSCC), adjacent non-cancerous, cervical intraepithelial neoplasia (CIN), and normal cervical tissues was detected by quantitative real-time PCR and/or immunohistochemistry. After transfection of pENTER-S100A11 or sh-S100A11-1/sh-S100A11-2, the viability, cell cycle, migration and invasion of C33A or SiHa cells were detected. The tumor volume and tumor weight were measured after injection of transfected C33A cells into mice. The expression of E-caherin (CDH2), N-caherin (CDH1), β-catenin (CTNNB1), and c-Myc (MYC) in C33A and SiHa cells was detected by Western blot. Results The expression of S100A11 was significantly higher in CSCC tissues than in adjacent non-cancerous, CIN, and normal cervical tissues (P < 0.05). S100A11 expression was positively correlated with the FIGO stage and lymph node metastasis of CSCC patients (P < 0.05). The transfection of pENTER-S100A11 into C33A cells significantly increased the cell viability, the percentage of cells in G2/M phase, the numbers of migratory and invasive cells, as well as the tumor volume and weight in mice (P < 0.05). Overexpression of S100A11 also significantly downregulated E-caherin, and upregulated N-caherin, β-catenin, and c-Myc in C33A cells (P < 0.05). The transfection of sh-S100A11-1/sh-S100A11-2 exhibited the opposite results to that of pENTER-S100A11 on SiHa cells. Conclusion Overexpression of S100A11 promotes the proliferation, migration, invasion, and epithelial-mesenchymal transition of CC cells, and activates Wnt/β-catenin signaling.

Objective Cervical cancer is a common gynecologic cancer, and no study has been reported on the way through which lncRNA SNHG1, miR-195 and NEK2 jointly affect cervical cancer cells (CCCs), so this paper will explore a new approach to the development of cervical cancer in this respect. Methods Altogether 72 cervical cancer tissues and 54 adjacent tissues were collected. qPCR was performed to quantify lncRNA SNHG1 and miR-195, whose expression vectors were constructed and then transfected into CCCs, so as to observe their effects on the cells. Western blotting (WB) was carried out to detect protein levels. MTT assay was conducted to detect cell activity. Flow cytometry was performed to detect cell apoptosis. Transwell was carried out to detect cell invasion and migration. Results The expression of lncRNA SNHG1 up-regulated while that of miR-195 down-regulated in CCCs. lncRNA SNHG1 regulated NEK2 through its targeted binding to miR-195. The down-regulation of lncRNA SNHG1 or the up-regulation of miR-195 led to the decrease of NEK2 and the reduction of cells’ activity, migration and invasion, also resulting in the increase of cell apoptosis. Rescue experiments showed that the down-regulation of miR-195 could offset the cell changes caused by lncRNA SNHG1. Conclusion lncRNA SNHG1 promotes the progression of cervical cancer through the miR-195/NEK2 axis, so lncRNA SNHG1, miR-195 and NEK2 may have potential values for diagnosing and treating cervical cancer.

Background Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a challenging situation. Methods We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis twice, reviewed the relevant literature, and summarized the characteristics of this disease. Results We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The summarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was 33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous nephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%) and conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years posttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure (ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed. The patient recovered well after surgery, except for a 3 mm residual stone in the calyx after the second surgery. He had normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict follow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later. Conclusions Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may have delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two or more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders and avoiding UIT are key measures to prevent the recurrence of lithiasis.

To stipulate the rationale of spraying doses and to determine the safe interval period of boscalid suspension concentrate (SC), the degradation dynamics and residual levels were investigated in cucumber and soil using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Field trials were conducted according to Chinese Guideline on pesticide residue trials. Following application, the degradation kinetics was best ascribed to first-order kinetic models with half-life of 2.67-9.90 d in cucumber. Spraying boscalid SC at 1.5-fold the recommended dosage yield terminal residues, which are clearly lower than the maximum residue limit (MRL) established by China (MRL =5 mg.kg

Background Renal transplant is the preferred treatment option for these patients with end-stage renal disease. Transplant renal artery stenosis (TRAS) is one of the most common and serious vascular complications after renal transplantation, and most of the TRAS occurred in the anastomosis. The complication must be diagnosed and treated timely, otherwise the function of transplanted kidney may be losed. Case presentation A 46-year-old male with end-stage renal disease of unknown cause received a cadaveric renal transplant one year ago. Although three antihypertensive medications were administrated, his blood pressure gradually increased to 190/120 mmHg 3 weeks posttransplantation. Also the level of creatinine increased to 194 μmol/L.Color Doppler ultrasonography indicated a decreased resistance index (RI) in intrarenal arteries and increased blood flow of the transplant renal artery, therefore, a vascular complication of TRAS was suspected. Arteriography was performed and demonstrated TRAS caused by stretch of an artery branch, and the TRAS occurred in the distal site of the anastomosis instead of the anastomosis. Percutaneous transluminal bare stent implantation treatment was successfully performed. Satisfactory clinical efficacy with improvement in transplant renal function and renovascular hypertension was achieved after the interventional treatment. Conclusion To our knowledge this is the first reported case of TRAS caused by stretch of an artery branch. When refractory hypertension and allograft dysfunction are presented posttransplantation, TRAS should be suspected. Color Doppler ultrasonography as a non-invasive examination may provide some valuable information, three-dimention CT can be useful for further diagnosis, but is seldom necessary. Arteriography provides the definitive diagnosis of TRAS. Percutaneous transluminal stent implantation treatment of TRAS has high success rate with minimal invasion and complications. When an artery branch situated on the stenosis, a bare stent rather than covered stent is the preferred choice.

This paper looks into the influences of martensitic transformations on the cavitation-erosion (CE) damage initiation mechanism and pitting corrosion resistance of a lean austenitic stainless steel. The ε and α' martensites are prime sites of CE damage initiation for this steel, whereas grain boundaries are more favourable damage initiation sites for other similar steels. The profusion of ε and α' results in fast surface roughening during the CE process, which may cause a compromise in performance when this steel (or similar steels that have the same CE damage mechanism) is used for such applications as hydro-machinery or piping. ε and α' also detrimentally affect the pitting resistance of this steel and so they are expected to affect CE resistance adversely due to the synergism between CE and corrosion.

A new Zn(II)-based coordination polymer (CP) [Me2NH2][Zn3(OH) (L)2(H2O)3]·6H2O (1) has been successfully prepared utilizing a ligand of 4,4′,4″-s-triazine-1,3,5-triyltri-m-aminobenzoate (H3L) with triazine backbone. Complex 1 could be applied as a Fe3+ sensor with high sensitivity and selectivity. Furthermore, the treatment activity of 1 against vulvar lichen sclerosus (VLS) was assessed and its particular mechanism was discussed in the study. Firstly, the titer of the Borrelia burgdorferi (B.burgdorfert) was measured. Then the flow cytometry was carried out to determine the relative content of the T cell subset in peripheral blood. The superoxide dismutase (SOD) and malondialdehyde (MDA) method was used to measure the level of the SOD activity and MDA. Reverse transcription-polymerase chain reaction (RT-PCR) was carried out for the determination of the inflammatory genes nf-κb and p53 relative expression. The apoptosis of the vulvar disease tissue was evaluated.

Summary Aim As a substrate of cytochrome P450 (CYP) 3A5, tacrolimus is characterised by a narrow therapeutic index and large inter-individual variability. Our objective was to determine the influence of CYP3A5 genetic polymorphisms on tacrolimus pharmacokinetics and acute rejection in Chinese renal transplant recipients. Methods Thirty-five renal recipients treated with tacrolimus in our centre were genotyped for CYP3A5 single nucleotide polymorphisms, CYP3A5*1 (6986A) and CYP3A5*3 (6986G). These patients were divided into the following three groups: CYP3A5*1*1 homozygous carriers, CYP3A5*3*3 homozygous carriers and CYP3A5*1*3 heterozygous carriers. Doses administered at 1 week and at 1, 6 and 12 months posttransplantation were recorded. Whole blood concentration was measured using the enzyme-multiplied immunoassay technique. Biopsy-proven acute rejection episodes (BPAR) reported during the first year after transplant were obtained retrospectively. Results The concentration/dose ratios of CYP3A5*3 homozygous carriers at 1 week and at 1, 6 and 12 months were significantly higher than the ratios among CYP3A5*1 carriers (CYP3A5*1*1 and CYP3A5*1*3, p

In recent years, researching the stability of the CNC machining process is a hotpot in CNC industry. Based on cDAQ and labVIEW, online monitoring system is presented, meanwhile, both software structure and hardware structure are introduced in detail. Researches show that vibration and pressure are the main factors for the quality of the flatness. By studying the relative vibration between the spindle and the platform in the Z axis direction, as well as the shifty pressure that tool works on the flatness of the workpiece, four experiments are designed in this paper under different technological conditions including free moving, Axial Depth of cut, speed and feed speed, which verify the reliability of the online monitoring system.

Background: This study was aimed to analyze the outcome of simultaneous pancreas–kidney transplantation (SPK) for diabetic uraemic patients at the China Medical University. Methods: Thirteen SPK transplants were performed between September 1999 and March 2002 including seven cases of type 2 insulin-dependent diabetic patients (Table 1). Results: No primary nonfunctioning of grafts occurred in our series. For type 1 diabetic patients, insulin independence occurred within 1.5 to 23 h after pancreas revascularization, while for type 2 diabetic patients, insulin could be withdrawn within 5 to 9 days after transplant. Except for one patient who lost her grafts to an accelerated rejection, the remaining patients survived with functioning pancreas and kidney grafts regardless of type of diabetes. In addition, these patients experienced improvement in secondary complications of diabetes (Table 2). Conclusions: SPK is the most effective treatment for diabetes with end stage renal disease (ESRD) including type 2 insulin-dependent diabetic patients in our experience. Graft procurement and preservation, surgical technique and perioperative management are important to prevent complications and to gain a perfect outcome.

This paper proposes a novel saliency object detection method by using the mid-level and high-level visual cues. In the mid-level objectness evaluation, we generate three complementary saliency maps, such as the multi-scale segmentation cue, the background cue and the spatial color distribution cue. The first cue is used to highlight the objects via the local region segment. The second cue uses the background priors to detect the saliency information. The third cue is to capture the spatial color distribution. For the high-level visual cue, we propose an objectness evaluation model to distinguish the object and the background. All the saliency cues are finally combined to achieve the saliency detection. The experimental results show that the proposed method outperforms the state-of-the-art saliency object detection methods.

BackgroundNon-alcoholic fatty liver disease (NAFLD) is one of the most prevalent liver diseases around the world, and is closely associated with obesity, diabetes, and insulin resistance. Ursolic acid (UA), an ubiquitous triterpenoid with multifold biological roles, is distributed in various plants. This study was conducted to investigate the therapeutic effect and potential mechanisms of UA against hepatic steatosis in a high-fat diet (HFD)-induced obese non-alcoholic fatty liver disease (NAFLD) rat model.Methodology/principal findingsObese NAFLD model was established in Sprague-Dawley rats by 8-week HFD feeding. Therapeutic role of UA was evaluated using 0.125%, 0.25%, 0.5% UA-supplemented diet for another 6 weeks. The results from both morphologic and histological detections indicated that UA significantly reversed HFD-induced hepatic steatosis and liver injury. Besides, hepatic peroxisome proliferator-activated receptor (PPAR)-α was markedly up-regulated at both mRNA and protein levels by UA. Knocking down PPAR-α significantly inhibited the anti-steatosis role of UA in vitro. HFD-induced adverse changes in the key genes, which participated in hepatic lipid metabolism, were also alleviated by UA treatment. Furthermore, UA significantly ameliorated HFD-induced metabolic disorders, including insulin resistance, inflammation and oxidative stress.Conclusions/significanceThese results demonstrated that UA effectively ameliorated HFD-induced hepatic steatosis through a PPAR-α involved pathway, via improving key enzymes in the controlling of lipids metabolism. The metabolic disorders were accordingly improved with the decrease of hepatic steatosis. Thereby, UA could be a promising candidate for the treatment of NAFLD.

Biological system shows a good robustness in nature environment. The purpose of the research of bio-inspired electromagnetic protection is to acquire the thoughts from biology and design the electronic system which has a good capability of anti-interference and high reliability. The paper presents a novel idea that studying bio-inspired electromagnetic protection based on pulsed neural network. The characteristic of pulsed neuron circuit is analyzed and the trait of anti-interference is simulated with Hspice. The simulation results show that the network constructed by pulsed neuron can better resist the pulsed interference. Hence, it is an important approach to investigate the technology of bio-inspired electromagnetic protection based on pulsed neural network.

To solve the problems of the unknown of ordinary FPGA configuration bitstreams and long time for download configuration bitstreams into ordinary FPGA in evolvable hardware, multilayer feed forward neural network was combined with virtual reconfigurable circuit to build MFNNVRC in an ordinary FPGA. This MFNNVRC structure was used to implement the control circuit of three phase brushless DC motor. In order to validate the effectiveness of this circuit design, a self-recovery experiment was carried out in the FPGA with some given partial faults. The successful result of experiment argues that the proposed circuit is a befitting evolutionary reconfigurable platform utilizing ordinary FPGAs for combinational logic circuits.

To evaluate the correlations between MELD score and left ventricular function in patients with end-stage liver disease.A total of 92 patients who prepared for orthotopic liver transplantation from January 2002 to May 2008 were enrolled in this study. Of these Patients, 75 were males and 17 were females, and the mean age was 50.3+/-9.5 years; 85 were cirrhosis, 7 were cirrhosis with primary liver cancer. Preoperative information, including biochemical parameters, coagulation parameters, indicators of hepatitis virology, two-dimensional echocardiography and electrocardiogram were collected. According to MELD (the Model for End-stage Liver Disease) scoring system, these subjects were categorized into three groups: MELD score is less than or equal to 9 points (31 cases, 33.7%); 10 is less than or equal to MELD score is less than or equal to 19 points (45 cases, 48.9%); MELD score is more than or equal to 20 points (16 cases, 17.4%). The relationships between MELD score and classification and cardiac function were determined by chi-square test, analysis of variance, rank sum test and correlation analysis, et al.MELD score was significantly correlated with left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular end-diastolic diameter (LVEDD), aortic flow (AF), cardiac output (CO), QRS interval (QRSI) and corrected QT interval (QTc) (r = 0.317, 0.341, 0.228, 0.387, 0.325, 0.209 and 0.347, respectively; P value less than 0.01, respectively); except QRSI, these variables and left ventricular posterior wall thickness (LVPWT) were also correlated with INR (a MELD component) (r = 0.282, 0.319, 0.322, 0.435, 0.275, 0.320 and 0.237, respectively; P value less than 0.01, respectively); LAD, LVEDD, AF, CO and QTc were correlated with serum total bilirubin (r = 0.241, 0.219, 0.357, 0.246 and 0.253, respectively; P value less than 0.05, respectively); IVST and E/A ratio (A blood flow [from left atrium to left ventricular] velocity ratio between early diastole [E wave] and late diastole[A wave] ) were correlated with serum creatinine (r = 0.216 and -0.343; P value less than 0.05 and 0.01); the proportion of E/A is less than or equal to 1 in all subjects was 46.7% (43/92), and 48.4% (15/31), 35.6% (16/45) and 75.0% (12/16) in each group, besides, there was statistically significant difference between 10 is less than or equal to MELD score is less than or equal to 19 points group and MELD score is more than or equal to 20 points group (X2 = 7.359, P = 0.009).There are different degrees of left ventricular structure, function and electrophysiological changes in patients with end-stage liver disease, these anomalies also will be increased with the MELD score increasing.

The provision of Quality of Service (QoS) in wireless network becomes very important. IEEE 802.11e standard was introduced to enhance the Media Access Control (MAC) layer operations to provide the QoS experienced by traffic flows. But only IEEE 802.11e can not guarantee network congestion avoidance and traffic QoS especially to multimedia traffics. So, an efficient admission control scheme is necessary to transmit multimedia traffic in high efficiency and quality. At present many admission control schemes have been proposed, in this paper we overall summarize the purpose, basic components, and classifications of admission control. And then present a survey of admission control in IEEE 802.11e EDCA and HCCA,these admission control schemes are discussed according to different categories: Measurement-Based, Model-Based, Hybrid schemes of EDCA and Physical-Rate and Contention-Window-Based of HCCA in IEEE 802.11e WLANs. Finally we will compare these schemes to get the advantages and disadvantages and point out the remaining challenges which are useful for us to study the admission control under heterogeneous networks and make admission control schemes accurate and simple.

To study the prevention and treatment of biliary complications after orthotopic liver transplantation.Clinical data of 183 recipients who had received liver transplantation between May 1995 and December 2006 were retrospectively analyzed.Biliary complications occurred in 15 patients (15/183, 8.2%). The incidence for short-term and long-term complication were 6.0% (11/183) and 2.2% (4/183) respectively. No biliary complications was due to hepatic artery thrombosis(HAT). Four cases who received PTC(percutaneous transhepatic cholangiography) with stent insertion,8 cases who received ERCP( endoscopic retrograde cholangiopancreatography) with stent insertion and 1 who received Roux-en-Y choledochojejunostomy for anastomotic stricture were successfully cured. Two cases required relaparotomy died for fungus infection eventually. The mortality due to biliary complications was 1.1%.The rapid combined abdominal organ harvesting technique could shorten the ischemia time and ameliorate the injury due to vascular and bile duct variances, which could reduce the incidence of biliary complication. PTC and (or) ERCP combined with stent insertion were main procedure for biliary complications not related to HAT after liver transplantation.

To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney (SPK) transplantation.Seventeen patients underwent SPK transplantation from September 1999 to September 2003 were reviewed retrospectively. Immunosuppression was achieved by a triple drug regimen consisting of cyclosporine, mycophenolate mofteil (MMF), and steroids. Three patients were treated with anti-CD3 monoclone antibody (OKT3, 5 mg x d(-1)) for induction therapy for a mean period of 5-7 days. One patients received IL-2 receptor antibodies (daclizumab) in a dose of 1 mg x kg(-1) on the day of transplant and the 5th day posttransplant. One patient was treated with both OKT3 and daclizumab for induction.No primary non-functionality of either kidney or pancreas occurred in this series of transplantations. Function of all the kidney grafts recovered within 2 to 4 days after transplantation. The level of serum creatinine was 94 +/- 11 micromol/L on the 7th day posttransplant. One patient experienced the accelerated rejection, resulting in the resection of the pancreas and kidney grafts because of the failure of conservative therapy. The incidence of the first rejection episodes at 3 months was 47.1% (8/17). Only the kidney was involved in 35.3% (6/17); and both the pancreas and kidney were involved in 11.8% (2/17). All these patients received a high-dose pulse of methylprednisone (0.5 g x d(-1)) for 3 days. OKT3 (0.5 mg x d(-1)) was administered for 7-10 days in two patients with both renal and pancreas rejection. All the grafts were successfully rescued.Rejection, particularly acute rejection, is the major cause influencing graft function in SPK transplantation. Monitoring renal function and pancreas exocrine secretion, and reasonable application of immunosuppressants play important roles in the diagnosis and treatment of rejection.

To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney transplantation (SPK).Seventeen patients performed SPK operation from Sep, 1999 to Sep, 2003 were reviewed retrospectively. Immunosuppression was achieved by triple regimen consisting of cyclosporine, mycophenolate mofetil (MMF)/azathioprine and steroid. 2 patients were treated with Dalizumab, the other three patients used OKT3 as immune induction.1 patient experienced the accelerated rejection, the pancreas and kidney grafts were resected because of failure of conservative therapy. 8 patients experienced renal acute rejection, 2 cases suffered from pancreas acute rejection at the same time. All these patients received daily high dose pulse steroid for 3 days. OKT3 was administered in 2 patients with steroid resistance rejection. All the grafts were successfully rescued.Reasonable application of immunosuppression after SPK operation and adoption of systemic measures which can reduce sensitivity of high risk receptor before SPK operation are the effective methods of preventing and treating rejection.

as PDNET, and 7 PDNEC based on morphologic features. WDNETs had low-grade cytology and mitotic figures less than 20 per 10 high-power fields. PDNECs demonstrated high grade cytology, sheet-like growth, and higher mitotic activity. PDNETs had intermediate features. Ki-67, p53, and p16 expression data are shown in Table 1. P53 expression in less than 30% of the tumor was considered negative. Conclusion: Tumors with morphologic features of well-differentiated neuroendocrine tumors do not express p53 and rarely express p16. Poorly-differentiated neuroendocrine tumors exhibit Ki-67 indices between 15-40%, with intermediate expression of p53 and p16. Poorly-differentiated neuroendocrine carcinoma with Ki-67 expression greater than 40% had the highest levels of p53 and p16 expression and the worst survival from the time of diagnosis. These data support the hypothesis that patients with neuroendocrine neoplasms of the gastrointestinal tract currently classified as grade 3 (neuroendocrine carcinoma) have variable survival. Further stratification of these patients based on proliferative indices may better predict clinical behavior, and further investigation with larger cohorts is warranted. Moreover, these data suggest expression of p53 and p16 by immunohistochemistry correlate with increasing grade and worse survival, and these markers may be useful in stratifying patients. Table 1