Changes of hyaluronic acid,laminin and collagen typeⅣwithin the renal grafts and in serum during acute rejection / 中华器官移植杂志

Objective To study the change of the hyaluronic acid (HA),laminin (LN) and col- lagen type IV (C_(?)) within the renal grafts and in serum during acute rejection and to investigate their relationship.Methods Male Wistar and Sprague-Dawley rats were used as donors and recipients,re- spectively.Rat orthotopic kidney transplantation was performed according to a modification of the method decribed by Biota.Experimental rats were randomly divided into 4 groups,homotransplanta- tion rats treated with cyclosporine,isotransplantation,pseudooperation and controls.Animals were subsequently killed at defined time points for determination of the extracellular matrix (ECM) parame- ters (HA,LN and C_(?)) within the graft and in serum by radioimmunoassay.Results Significant increases in HA,LN and C_(?) levels within the renal grafts were found in the rejection group as compared with the non-rejection groups.Serum levels of HA,LN and C_(?) were also significantly elevated in the rejection group at diagnosis of rejection.Serum HA,LN and C_(?) levels were correla- ted with those within the renal grafts.Histologic examination revealed that 4 cases developed acute re- jection in homotransplantation rats treaded with cyclosporine,17 cases in controls.HA,LN and C_(?) levels within the renal grafts were correlated with acute rejection Banff scores.There was correlation between serum levels of HA,LN and C_(?) and acute rejection Banff scores (P＜0.01).Conclusion HA,LN and C_(?) play an important role in the pathogenesis of acut allograft rejection.In addition, serum levels of HA,LN and C_(?) may be a sensitive marker of acute rejection in the postoperative period of renal transplantation.

Free graft two-stage urethroplasty for hypospadias repair / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the effectiveness of free graft transplantation two-stage urethroplasty for hypospadias repair.</p><p><b>METHODS</b>Fifty-eight cases with different types of hypospadias including 10 subcoronal, 36 penile shaft, 9 scrotal, and 3 perineal were treated with free full-thickness skin graft or (and) buccal mucosal graft transplantation two-stage urethroplasty. Of 58 cases, 45 were new cases, 13 had history of previous failed surgeries. Operative procedure included two stages: the first stage is to correct penile curvature (chordee), prepare transplanting bed, harvest and prepare full-thickness skin graft, buccal mucosal graft, and perform graft transplantation. The second stage is to complete urethroplasty and glanuloplasty.</p><p><b>RESULTS</b>After the first stage operation, 56 of 58 cases (96.6%) were successful with grafts healing well, another 2 foreskin grafts got gangrened. After the second stage operation on 56 cases, 5 cases failed with newly formed urethras opened due to infection, 8 cases had fistulas, 43 (76.8%) cases healed well.</p><p><b>CONCLUSIONS</b>Free graft transplantation two-stage urethroplasty for hypospadias repair is a kind of effective treatment with broad indication, comparatively high success rate, less complications and good cosmatic results, indicative of various types of hypospadias repair.</p>

Combined use of urinary bladder cancer antigen,hyaluronic acid and survivin for the detection of bladder cancer / 中华泌尿外科杂志

Objective To assess the diagnostic value of combined testing of urinary bladder cancer antigen(UBC),hyaluronic acid(HA)and survivin in the detection of bladder cancer.Methods This study included 64 bladder cancer patients and 20 urinary benign disease patients.The examinations of urine UBC by enzyme-linked immunosorbent assay(ELISA),HA by radioimmunology assay,survivin by RT-PCR and urine cytology were performed in them.Results The sensitivity of UBC(85.9%,55/64),HA (89.1%,57/64)and survivin(93.8%,60/64)was significantly higher than that of urine cytology (40.6%,P＜0.01).The specificity of UBC,HA,survivin and urine cytology was 85.0%(17/20),80.0% (16/20),95.0%(19/20)and 95.0%(19/20),respectively;there was no significant difference among these 4 methods(P＞0.05).The sensitivity of UBC,HA and survivin was also significantly higher than that of urine cytology in different histologic stages and grades(P＜0.05).The sensitivity of UBC and survivin was not significantly different among different histologie stages and grades(P＞0.05).With regard to HA test, the sensitivity in G_2 and G_3 groups was significantly higher than G_1 group(P＜0.01),but there was no differ- ence between G_2 and G_3 groups(P＞0.05);and no difference among different histologic stages(P＞0.05). However,the sensitivity of cytology was improved with the higher grade of bladder cancer(P＜0.01);there was no difference among histologic stages(P＞0.05),By combined use of UBC,HA and survivin,both the sensitivity and specificity were 100%.Conclusions The study indicates that UBC,HA and survivin are better diagnostic markers for the early detection of urinary bladder cancer.These tests are simple,feasible and noninvasive with higher sensitivity and specificity.In addition,combined use of them can improve the diag- nostic sensitivity and specificity.