ABSTRACT
Objective To evaluate the efficacy and safety of basiliximab (BAS) and antithymocyte globulin (ATG) in immune induction therapy in kidney transplantation by systematic review and Meta-analysis. Methods Prospective randomized controlled clinical trials screening and comparing BAS and ATG in immune induction therapy in kidney transplantation were systematically searched from global databases, screened and compared. The quality of clinical trials was evaluated by Jadad scoring system and data extraction was performed. The effects of BAS and ATG on the incidence of acute rejection, survival rate of kidney allografts, survival rate of recipients, incidence of delayed graft function, infection, cytomegalovirus infection, malignant tumor, leukopenia and thrombocytopenia at 1 year after kidney transplantation were analyzed. Results A total of 10 clinical trials in English consisting of 1 721 kidney transplant recipients were searched, including 883 cases in the ATG group and 838 cases in the BAS group. No significant differences were observed in the incidence of acute rejection, survival rate of kidney allografts, survival rate of recipients, incidence of delayed graft function, infection, cytomegalovirus infection and thrombocytopenia at postoperative 1 year between the ATG and BAS groups (all P > 0.05). The incidence of malignant tumor and leukopenia at postoperative 1 year in the ATG group were significantly higher than those in the BAS group (both P < 0.05). Conclusions The use of ATG and BAS for immune induction therapy in kidney transplantation yield equivalent efficacy at postoperative 1 year, but BAS is safer than ATG. Clinical trials related to stratified analyses of immune risk are urgently required to achieve individualized precision treatment.
ABSTRACT
Objective To determine the feasibility and safety of transprostatic utricle seminal vesiculoscopy in the treatment of hemospermia. Methods Totally 11 patients with hemospermia, mean age of (46.6 ± 3.5) years, ranging from 38 to 68 years, for 3 months admitted from September 2012 to August 2015 were enrolled, Their main manifestations were hemospermia. Painful ejaculation was observed in 7 patients, and perineal and testicular pain occured in 4 patients. They all underwent transprostatic utricle seminal vesiculoscopy, and then were followed up for 3 to 6 months. Results Ten patients were operated successfully, but 1 patient failed. The operation revealed that the causes of hemospermia were seminal vesiculitis in 8 cases, seminal vesiculitis accompanied with seminal calculi in 2 cases, and ejaculatory duct cyst in 1 case. Operation time was (29.2 ± 3.2) min ( ranging from 25 to 37 min) , and hospital stay was 2 d ( from 2 to 4 d). Hemospermia disappeared in 10 patients within 1 month of surgery, and hemospermia recurrence was observed in 1 patient within 6 months. The patient was treated with transprostatic utricle Holmium laser incision, then hemospermia was dispeared,Two cases of postoperative epididymitis were cured after one week of antibiotic treatment. Conclusions Seminal vesiculoscopy is a safe and effective to treat hemaospermia.