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Objective:To explore the feasibility and efficacy of kidney transplantation with pediatric donors to pediatric recipients (PTP) according to the quality control parameters of kidney transplantation in China.Methods:From September 2011 to September 2019, the clinical data were reviewed for 147 children undergoing kidney transplantation. The general status of donors and recipients, survival rate and complications of transplantation were analyzed.The median age was 130(21-270) month and the median weight 26.0(8.5-71.5) kg. The median age of 120 donors was 12 month (4 day-180 month) and the median weight 9.3(2.5-50.0) kg.Results:After a follow-up period of 10 days to 9 years, the cumulative survival rates of patients and grafts were 97.3% and 88.8%. The cumulative survival rates of patients and grafts were 95.7% and 60.9% in en bloc kidney transplant recipients versus 96.8% and 94.2% in single kidney transplant recipients. The major complications of en bloc kidney transplantation were graft thrombosis (47.8%) and ureteral complications (17.4%). Single kidney transplantation was characterized by delayed graft function recovery (DGF, 18.6%) and acute rejection reaction (10.5%). Two cases died from donor-derived infection after transplantation, one from cytomegalovirus infection and one from epileptic seizure.Conclusions:PTP kidney transplantation is effective. Organ matching and optimal operative mode selection are essential. Preventing postoperative thrombosis for avoiding an early graft loss has remained a high priority during PTP kidney transplantation.
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Objective To observe whether treatment with cannabidiol (CBD) affect nonalcoholic steatohepatitis (NASH) induced by methionine choline-deficient diet (MCD) in rats and investigate the underlying molecular mechanism. Methods Sixty-three adult male SD rats were randomly divided in to three groups as follows: Control group (rats fed with normal diet), MCD group (rats fed with MCD and MCD+CBD group [rats fed with MCD and treated with cannabidiol, 2mg/(kg.d), i.p.]. Ten weeks later, steatohepatitis and fibrosis were evaluated by hematoxylin-eosin and Masson staining, respectively. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by using an automatic biochemical analyzer and hepatic levels of cholesterol and triacylglycerol were determined with kits. Autophagic flux in livers was evaluated by Western blotting. Results Treatment with cannabidiol reduced ratio of liver/body weightratio (4.2%±0.6% versus 3.1%±0.6%, P<0.05), histological scores (4.7±1.1 versus 2.2±0.5, P<0.05) and fibrosis (1.4%±0.4% versus 0.8%±0.3%, P<0.05) in rat livers, lowered levels of ALT (214.5±54.1U/L versus 92.1±36.0U/L, P<0.05) and AST (175.9±55.2U/L versus 70.8±24.9U/L, P<0.05) in serum, attenuated hepatic fat accumulation (cholesterol, 182.4±42.7mmol/mg protein versus 101.0±33.8mmol/mg protein, P<0.05; triglyceride, 71.4±12.5mmol/mg protein versus 38.7±11.1mmol/mg protein, P<0.05), and down-regulated mRNA expression of Col1A1 (2.9±0.4 versus 1.6±0.3, P<0.05) in livers of rats fed with MCD. Furthermore, cannabidiol led to the LC3 turnover (LC3-Ⅱ/LC3-I, 37.1±10.8 versus 71.2±17.1, P<0.05) and p62 decrease (202.4±40.9 versus 125.8±32.7, P<0.05) in the livers of MCD-fed rats. Conclusion Treatment with cannabidiol could relieve MCD-induced NASH in rats, at least in part, by autophagic flux promotion.
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Objective To analysis the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of these patients were suffered from OSAHS.The patients were divided into two groups,control and OSAHS group,according to whether were accompanied by OSAHS or not.Both of the groups received the routine treatments including dehydration,reducing blood press,protecting the cerebral cells and so on.Cerebral CT scan was taken on admission.Night polymonography (PSG) was done within 24 hours of admission.Twenty-four hours and 4 days after admission,cerebral CT scan was taken again.The volumes of cephalophyma and perihematoma edema were calculated according to the results of CT scan.The changes of cephalophyma and perihematoma edema were dynamic observed.Results No difference in patients' age,sex,body mass index,serum glucose,blood lipid and so on,was observed between the two groups.The relative edema index became significantly different until 4 days after admission (0.40 ± 0.45,0.96 ± 1.35 in control and OSAHS group respectively,t =4.149,P =0.000).Similarly,the alternation edema index of OSAHS was obviously higher than that of control group only in 4 days after admission.While the analysis of the correlation between different degree OSAHS groups and edema indexes showed that at 24 hours after admission the edema volumes for different degree OSAHS groups were consistent (1.05 ± 0.65,0.84 ± 0.48,1.20 ± 0.54,1.10 ±0.40 in control,slight,moderate and severe groups respectively,F =1.061,P =0.374).At 24 hours and 4 days after admission,the edema volumes were positively correlated with the degree of OSAHS.Alternation edema index was significantly correlated with apnea hypopnea index according to the result of Pearson' s correlation analysis (r =0.652,P =0.000).Conclusion OSAHS complication can promote the progression of perihematoma edema of hypertensive cerebral hemorrhage,and the degree of edema aggravation is positive correlated to the degree of OSAHS.
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Objective To investigate the surgical options for the management of portal vein thrombosis (PVT) during liver transplantation and its impact on the outcome of patients. Methods 773 cases of liver transplantation were analyzed retrospectively. PVT occurred in 107 patients, inclu-ding 59 of grade Ⅰ ,33 of grade Ⅱ, 12 of grade Ⅲ and 3 of grade Ⅳ. Simple thrombectomy or thrombus-extraction was performed in grade Ⅰ and Ⅱ. 12 patients with grade Ⅲ received thrombus-extraction or using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases of grade Ⅳ received a modified cavo-portal hemitransposition and one case received portal-vena coronaria varication anastomosis. Results Liver function had a good recover and the perio-perative mortality is 4. 3% in grade Ⅰ and Ⅱ. In grade Ⅲ , 5 cases received thrombus-extraction had a normal liver function after transplantation and had no died. 2 cases among the other 7 cases using por-tal vein reconstruction had bad liver function and died. The liver function recovered well after trans-plantation and there was no died in grade Ⅳ. Conclusions PVT is not a contraindication for liver transplantation. Good results can be obtained by applying reasonable operative procedures individually.
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Objecfive To investigate multi-slice spiral CT(MSCT)appearances of pulmonary infections after liver transplantation(LT)and the diagnostic values of MSCT.Methods The clinical data and CT images of liver transplantation receptors were reviewed from 200 1 August to 2007 June,the types,onset time and CT appearances of pulmonary infections were analyzed retrospectively.Chi square test was used for the statistics.Results The incidence rate of pulmonary infections after LT was 32.9/(174/529),the mortality was 9.8/(1 7/174),The incidence of bacterial infection,fungus or associated fungus infection,and virus or associated virus infection were 17.2/(n=91),14.7/(n=78)and 2.3/(n=12)respectively,the pulmonary infections were seen in 64.7/,28.7/and 6.6/of patients 1 to 30 days,31-90 days and after 90 days following LT.Consolidations(n=32),ground-glass opacities(n=22),nodules(n=10),reticular or lineal opacities(n=4)were found in 45 patients who had CT examination,there were no statistic differences in incidence rate between bacterial infection and mycotic infection(P＞0.05).Conclusion Pulmonary bacterial and fungus infection are common after LT.and often present as the mixed infection,the high risk period for infection is within 30 days after LT,thoracic CT stall is very important for characterizing the pulmonary infections after LT.
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Objective To evaluate the therapeutic effects of liver transplantation (LT) for cholangiocarcinoma(CC)and analyze the prognostic factors.Methods From December 2001 to December 2006,234 patients receiving LT for hepatic carcinoma in our institute were enrolled as a basis of comparative study for 6 CC patients undergoing LT during the same period.Results These 6 patients were followed-up from 1 to 56 months.Five patients died and one recurred.The 0.5-,1-and 2-year patient cumulative survival rates were 4/6,3/6 and 1/6,respectively.The 0.5-,1-and 2-year tumor-free survival rates were 3/6,2/6 and 1/6,respectively.The average patient or tumor-free survival time were both(14±4) months.Conclusion The prognosis of cholangioearcinoma patients after LT iS poor.
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Objective To improve identification with regard and accuracy of diagnosis to CT appearances of pulmonary infections after liver transplantation(LT) .Methods CT findings of pulmonary infections after LT were retrospectively analyzed.Results The main CT manifestations included consolidation in 32(the lesions mostly in the right or both lower lung zones),ground-glass attenuation in 22,(the lesions distribution were often bilateral and diffuse),nodules in 10(multiple and bilateraly,the diameter of lesions was all less than 3 cm), and seven less than 1 cm,including diffuse and miliary nodules of lungs in 3,graticule or line shadows in 4,the lesions were in bilateral upper lobes in 2 and distribution extensively in bilateral lungs in 2.The most common CT findings of lung bacterial infection after LT were consolidation ,and ground-glass attenuation,while for pulmonary mycotic infection consolidation,ground-glass attenuation and nodule were all often seen.Conclusion CT is valuable to the diagnosis of pulmonary infections after LT.
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With rich materials, this paper discusses the important role of moral education in preventing and cure AIDS, which can not be replaced with laws or other forms. Also it refutes the viewpoints of using condom to prevent AIDS.