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Objective To investigate the management and prevention of the complications of sigmoid rectal pouch for urinary division after radical cystectomy. Methods The clinical data of 34 patients who underwent a sigmoid rectal pouch procedure were analyzed retrospectively, and the clinical experience was summarized in the management and prevention of the complications of sigmoid rectal pouch for diversion. Results Twenty-six patients were followed up for 2 months to 11 years, and 10 patients lost in follow-up. The early follow-up results were as follows:3 patients had postoperative high fever with unilateral the kidney water, 1 patient had retropubic bleeding and need to stop bleeding, 3 patients suffered from wound split open and were performed relaxation suture, and 1 patient had sigmoid colon rectum bladder fistula 10d after operation. The late follow-up results were as follows:1 patient had urethral neoplasms recurrence, 5 patients developed distance metastases, and 5 patients developed nocturnal incontinence and worn safety pad. There were no hyperchloremic acidosis requiring clinical treatment, hydronephrosis as well as retrograde pelvis infection. Conclusions The operation of sigmoid rectal pouch for urinary division is fairly simple, with no serious complication. It is a better alternative diversion procedure, and should be accepted gradually by patients and surgeons.
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Objective To measure the pressure-volume changes and uroflow rate,and assess the function of upper urinary tract in sigmoidorcctal pouch patients.Methods Between 2007 and 2011,a to-tal of 10 patients who had a radical cystectomy because of muscle-invasive bladder tumor underwent a Mainz pouch Ⅱ procedure were evaluated.The ureters were implanted into the post walls of the detubularized sigmoid segment at least 30 cm in length.In all cases,sigmoidoscopy was done and the anal pressure was measured preoperatively,and video urodynamic study of sigmoidorectal pouch as well as the intravenous pyelography was conducted after 3 to 6 months postoperatively.Results Video urodynamic study of sigmoidorectal pouch revealed that no reflux up to an average volume of 360 ml (270-532 ml) of the descending colon.The sigmoidal colon pressure was 26 cm H2O during the 3 to 6 months post-operative follow-up.The anal sphincter pressure was 90 cm H2O on average preoperatively and did not change postoperatively.The renal function and upper urinary tract were preserved well.The Qmax was 30 ml/s and the average uroflow rate was 8 ml/s under abdominal strain.All the patients suffered slight incontinence in the first two months and became continent since the 3 month postoperatively with nocturnal voiding one to four times.Conclusions The sigmoidorectal pouch provides a reservoir with a higher capacity,lower pressure without reflux to the upper urinary tract and descending colon and lower metabolic acidosis problem.It is also a good alternative diversion procedure that would preserve upper urinary tract and good quality of life.
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Objective To observe the immunosuppression function of a novel HLA-derived peptide, RDP1258, after rat renal transplantation in vivo.Methods Peptides were synthesized by Fmoc chemistry method. The rat renal heterotopic transplantation model (n=32) was established. The allograft rats were divided into 4 group: group A (n=8) receiving subtherapeutic CsA+RDP1258 peptide; group B (n=8) receiving RDP1258 alone; group C (n=8) receiving subtherapeutic CsA alone; and group D (n=8) receiving no immunosuppression. The renal allograft survival days of receptor rats were observed. Serum creatinine was measured and color Doppler flow imaging was checked. Renal tissues were harvested for light microscopic examination. The immunologic tolerance status of rat renal allografts was detected by MLR of 60th day receptor rat spleen cells cultured with the donor spleen cells and the third party.Results The allograft survival time in groups A, B, C and D were ( 63.4?30.6)days, (18.3?7.3)days, (16.9?6.4)days and (9.4?2.6)days, with the difference being significant between group A and other three groups. The results of MLR revealed that a hyporesponsiveness to donor occurred while the normal reaction to the third parity was retained.Conclusion A novel HLA derived peptide therapy combined with a sub-therapeutic dose of CsA significantly prolonged allograft survival days, and the mechanism might be that RDP1258 induced a donor-specific immunologic tolerance status in the recipients.
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Objective To investigate the management of external iliac artery mycotic hemorrhage after kidney transplantation. Methods A case of external iliac artery mycotic hemorrhage after kidney transplantation managed by the use of hypogastric artery autograft was reported with review of the literature.The massive blooding occurred 3 times after kidney transplantation in a male patient 25 years of age on the 22nd,24th and 38th day after transplantation.The blooding amounted to 800 ml,2500 ml and 3800 ml respectively.The blood loss was replaced and prompt surgical exploration was carried out with the blooding site at the anastomosis sutured up on the 1st and 2nd episode of bleeding.On the 3rd occurrence of bleeding, the diseased external iliac artery segment, about 2cm in length, was resected and the gap was replaced by a 3cm long hypogastric artery autograft. Results The blood flow through the repaired external iliac artery and the blood supply to the lower extremity was adequate.Periodic hemodialysis had been restored and the patient waited for reimplantation. Conclusions External iliac artery mycotic hemorrhage after kidney transplantation is a serious and fatal complication.Simple arterial repair is usually noneffective.Resection of the diseased mycotic segment of the external iliac artery with repairing of the gap with a hypogastric artery autograft is rational,feasible and simple.The procedure is highly recommended.
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Objective To investigate the therapeutic method of metabolic acidosis in long-term sur- vival patients undergoing simultaneous pancreas and kidney transplantation.Methods A 45-year-old fe- male patient,who had undergone simultaneous pancreas and kidney transplantation(due to diabetic ne- phropathy and uremia)with bladder drainage 2 years before,developed severe metabolic acidosis,and thus underwent surgical conversion from bladder to ileal drainage.The procedure was as follows.The stoma of duo- denocystostomy was isolated and resected.The site of cystostomy was closed in two layers.The graft duode- num was then anastomosed to a loop of the recipient's ileum,which was proximal 40 cm from the ileocecum in a side-to-side manner.Results The metabolic acidosis resolved postoperatively.The patient received conventional immunosuppressants.The hospital stay was 30d.Follow-up of 4 years showed normal pancreas and kidney functions.Conclusions Conversion from bladder to ileal drainage is safe and effective for metabolic acidosis related to the exocrine secretions of bladder drained pancreas graft in simultaneous pancre- as and kidney transplant recipients.
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Objective To study the effect of synthetic HLA-derived peptide (P), HLA-B*2702.75-84, on the mean survival time (MST) of cardiac allografts in mice.Methods NIH mice cardiac allografts were heterotopically transplanted into the posterior of Balb/c ears. The HLA-derived peptide in combination with a subtherapeutic dose of CsA were perioperatively administrated. The pulsation of the cardiac allograft observed under the operating microscope was considered as the indication of the cardiac allograft surviving time or rejection. Results MST was ( 7.5? 0.5) days in untreated control group, ( 8.5? 1.5) days in CsA group and ( 7.0? 1.5) days in control peptide or P groups respectively, whereas MST was ( 26.5? 3.5) days in experimental group.Conclusion The synthetic HLA-derived peptide combined with subtherapeutic CsA can significantly prolong cardiac allograft survival in mice as compared with control groups.
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Objective To investigate the effects of RDP1258 on survival of rat cardiac allograft. Methods RDP1258 was synthesized and the model of rat heart abdominal transplantation was established. Animals were divided into four groups. Group 1 received no immunosuppression. Group 2 received CsA alone. Group 3 received RDP1258 alone. Group 4 received RDP1258 and subtherapeutic CsA. In all cases RDP1258 was administrated intraperitoneally and CsA was gavaged. Light and electron microscopic examinations were taken . Transplanted hearts were monitored daily by direct palpation. Results The purity of synthesized RDP1258 was over 95 % and the molecular weight was in accord with theoretical value. The histology and the ultrastructure changed little in grafts in group 3 and group 4. Survival of rat cardiac allograft was significantly prolonged in group 4. Conclusions RDP1258 can suppress acute rejection. Perioperative administration of RDP1258 in combination with CsA can significantly prolong survival of rat cardiac allograft.
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Objective To observe the immunosuppression function of a novel HLA derived peptide, RDP1258, and to investigate the mechanisms. Methods The peptides derived from HLA, RDP1258, and HLA 2702.75 84 was synthesized chemically. The effects of the peptides on alloreactive cytotoxic activities of rat spleen cells were observed using 3H TdR incorporation method. The heme oxygenase 1 activity was detected by the enzyme chemistry method. Result The synthetic HLA derived peptides could obviously inhibit the proliferation of rat spleen cells and HO 1 activity in a dose dependent manner in vitro. Conclusion HO 1 may participate in the process of inhibitory effect of RDP1258 on the proliferation of rat spleen cells induced by mitogen or isoantigen.
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Objective: To study the immunosuppression function of a novel HLA-derived pepride, RDP1258,and it' s mechanisms. Methods:A peptide derived from HLA,RDP1258,was chemically synthesized.The effects of the peptide on alloreactive cytotoxic activities of rat splenocytes were observed using 3H-TdR method.The heme oxygenase-1(HO-1) activity was analyzed by the enzyme chemistry method.Results:The results showed that the synthetic HLA-derived peptide can obviusly inhibit the proliferation of rat splenocytes and the peptide inhibited HO-1 activty in a dose-dependment manner in vitro.Conclusion:HO-1 might participate in the RDP1258 inhibiting the proliferation of rat splenocytes induced by mitogen and isoantigen.
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In order to investigate the significance of prostacyclin and throm-boxere A2 in the pathegertsis of ischemic renal injury,the level of 6-keto-PGF1? and TXB2 in the plasma and the dissected slices of the kidneys of the rabbits with iscbemic renal injury was determined with RIA,It was found that 6-keto-PGF1? increased significantly in the outer and inner medullae,TXB2 increased significantly in all the renal slices,and the 6-keto-PGF1?/TXB2 ratio decreased significantly in the outer cortex 3 hours after reperfusion,The findings suggest that the imbalance between the synthesis of prostacyclin and thromboxane A2 might be resporsible for the decline and redistribution of renal blood flow in the early stage of acute ischemic renal failure.
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Objective To investigate the immunosuppression function of a novel HLA derived peptide, RDP1258, and its mechanisms. Methods A peptide derived from HLA, RDP1258, was chemically synthesized by artificial solid phase synthesis. Effects of the peptide on alloreactive cytotoxic activity of rat spleen cells and heme oxygenase 1 (HO 1) activity were observed using 3H TdR method and enzyme chemistry method, respectively. Results The synthetic HLA derived peptide could obviously inhibit the proliferation of rat spleen cells and mixed lymphocyte reaction, and reduce HO activity in a dose dependent manner in vitro . Conclusion RDP1258 can significantly inhibit the proliferation of rat spleen cells induced by mitogen and isoantigen possibly by means of affecting HO 1 activity.