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Objective To summarize the clinical data of renal transplants survived with graft function more than 10 years and the adverse events during this period, and to discuss the main strategies for the long-term survival Methods Survival rate of renal transplants simultaneously survived with graft function > 10 years and grafts was counted respectively in total 1003 renal transplant recipients at our hospital before Dec. 31,1998 retrospectively. Their relevant survival,adverse events and initial post-operative immunosuppressive regimens were recorded simultaneously.Results As of Dec. 31, 2008, the 10-year survival rate of recipients was 62. 7% (629/1003), and recipients with graft function accounted for 85. 37 % (537/629). Of them, 94. 75 % (596/629) recipients received cyclosporine A (CsA) -based immunosuppression plus other antiproliferative immunosuppressive agents. Post-transplantation adverse events included coronary heart diseases in 57 cases (9. 06 %), liver damage in 32 cases (5. 09 %), malignancy in 29 cases (4. 61% ), diabetic mellitus in 25 cases (3. 97 %), apoplexy in 16 cases (2. 54 %), severe bone marrow depression in 14 cases (2. 23 %), femur head necrosis in 7 cases (1.11%), lower-extremity thrombosis in 3 cases (0. 48 %), sudden deafness in 2 cases (0. 32 %). There were 690 survival patients and 49 deaths including 19 (38. 78 %) due to cardiocerebral vascular accidents, 10 (20. 41%) due to malignancy, 9 (18. 37 %) due to hepatic failure, 4 (8. 16 %) due to infection, 3 (6. 12 %) due to treatment abandonment, 2 (4. 08 %) unknown reasons and 2 (4. 08 %) accidental deaths. Conclusion Long-term survival after renal transplantation is associated with the primary medication of CsA as the main immunosuppressive regimen. The non-immunologic factors such as the prevention and cure of cardioeerebral vascular diseases and the early finding of liver functional abnormality and tumor are the main points focused during follow-up.
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Objective To explore the efficacy of transurethral resection of bladder neck(female)and urinary sphincter(male)to treat neurogenic urinary dysfunction. Methods Forty-one patients(28 women and 13 men)with neurogenic urinary dysfunction(dysuria)were retrospectively analyzed.All patients had sacral neurological damage.The mean patient age was 27(12-43)years.All patients had urinary retention and ureter dilation.Twenty-nine patients had renal function damage.Residual urine volume was 151-700 ml(mean 420 m1).MFR was 4-14 ml/s.After local anesthesia,bladder neck(female)was incised at 5,6,7 o'clock to the circle fiber.Urinary sphincter(male) was cut off at 11,1 o'clock and was dilated using sound(F24-F27).The catheterization time was 1-2 weeks. Results All 41 patients were followed up,from 2 months to 252 months,average 85 months.Thirty-six patients(88%)were completely recovered with no residual urine,no dilation of ureter and pelvis,no renal function damage.of these 36 cases,surgery was carried out once for 1 patient,twice for 20 and 3 times for 15.Five patients(12%)were not improved. Conclusion Transurethral resection of bladder neck(female)and urinary sphincter(reale)to treat neurogenic urinary dysfunction could be an effective method.
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Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999.Patient's mortality was calculated by the Kaplan Meier method.The factors which might lead to patients' death,including age and sex of the donors and recipients,frequency of transplantation,dialysis time and transfusion volume before transplantation,cold ischemic time (CIT),delayed graft fuction (DGF),rejection,immunosuppressive regimen,and post transplant complications,were analyzed by log rank and Cox model. Results Total mortalities of the patient at 1 ,5 ,10 ,and 15 year were 6.9%,19.7%,32.1%,and 34.7%,respectively.The leading causes of patients' death were infection,cardiocerebral vascular diseases,and hepatic failure.The factors of transplant times,dialysis time before transplant,immunosuppressive regimen,chronic rejection,post transplant complications of pneumonitis and cardiocerebral vascular diseases were significant impact on transplant patient death by the analysis of Cox model. Conclusions In this series of 1039 cadaveric kidney transplant patients,the mortality since the first year after transplantation was increased annually by 2.5% during the past 22 years.The leading causes of patients' death are infection,cardiocerebral vascular diseases,and hepatic failure after renal transplantation.Transplant times in which patients receive the procedures,dialysis time before transplant,immunosuppressive regimen,chronic rejection,post transplant complications of pneumonitis and cardiocerebral vascular diseases are significant factors impacting on transplant patients' death.
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Objective To evaluate the use of LHRH A for treating prostatic cancer with the occurrence of metastasis or recurrence after castration. Methods LHRH A has been instituted to 9 cases of pathologically verified prostatic cancer with the occurrence of metastasis or recurrence after castration.The therapeutic results were studied. Results Ideal improvement was noted in 4 with all the parameters turned normal.These 4 patients have survived well for 7,3,2 and 1 year respectively.Marked improvement occurred in 2 with part of the parameters turned normal or markedly improved shortly after the treatment.The condition of 1 patient became stable with drop of blood PSA and shrinkage of the prostatic mass.In 3 patients,the metastatic lesion became stable.with the use of LHRH A,the penis became markedly atrophic. Conclusions LHRH A is markedly effective in most cases of prostatic cancer with the occurrence of metastasis or recurrence after castration.The therapeutic efficacy depends on the sensitivity of the prostate cancer cells to the drug.Drug resistance may issue as time goes by.
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Objective: To evaluate the effects of antisense oligodeoxynucleotides (ODNs) (AS1 complementary to the translation initiation region and AS2 complementary to the coding region) targeted to bcl-2 oncogene on Bcl-2 protein expression and apoptosis of human renal cell carcinoma (RCC) cells. Methods; Expression of bcl-2 mRNA in RCC cell lines was analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR). The ODNs were transfected with Lipo-fectin into RCC cell lines. The expression of Bcl-2 protein in ACHN tumor cells was examined by Western blot analysis, and the apoptosis of those cells was determined by flow cytometric analysis. Results: Expression of bcl-2 mRNA was detected in all five RCC lines. Transfected bcl-2 antisense ODNs, but not sense ODNs, inhibited Bcl-2 protein expression in ACHN cells. The AS2 antisense ODN showed a superior effect compared with AS1 ODN. The apoptosis of ACHN cell could been induced by bcl-2 antisese ODNs , and percentage of apoptotic cells was noted 32. 1% and 43. 2% treated with AS1 and AS2, respectively. Conclusions: Treatment of human RCC cells with antisense ODNs targeting bcl-2 gene inhibits expression of Bcl-2 protein and induce apoptosis.