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Objective To analyze the reasons and outcomes of the unplanned re-operation in renal transplant recipients during perioperative period,and to summarize the corresponding strategies.Methods From January 2014 to September 2017,the clinical data of 20 cases of kidney transplantation which had a total of 22 unplanned re-operations were retrospectively analyzed.All patients were given quadruple immunosuppression with antibody induction and tacrolimus (TAC) and mycophenolate mofetil (MMF) plus prednisone (Pred).We analyzed the reasons,occurrence time,effect of re-operation and the renal function,as well as survival rate of all graft and recipient.The delayed graft function (DGF),acute rejection (AR) and incidence of pulmonary infection were monitored as well.Results Up to September 2017,during the follow-up of 1-36 months,the overall rate of unplanned re-operation was 4.6%,and 2 patients underwent 3 operations.For the reasons of re-operation,there were 18 cases of bleeding (13 cases of blood oozing from the wound surface,3 cases of renal parenchyma rupture because of rejection,and 2 cases of rupture of renal artery infection),2 cases of renal artery thrombosis and 2 cases of the repair of leakage of urine.Two operations were performed within 1 days for 9 cases,2-5 days for 5 cases,6-10 days for 3 cases,above 10 days for 45 cases.There was no deaths during the perioperative period.One patient died of rupture of exiliac aneurysm 3 months after the operation.One patient died of cerebral hemorrhage 6 months postoperation.The death censored graft survival rate was 72.2% (13/18) and the incidence of DGF was 55 %.Conclusion The major reason of unplanned re-operation for renal transplantation is associated with bleeding of various causes.And the incidence of DGF is high.If the secondary operation was performed with the correct decision,the kidney allograft recovers well.
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Objective To determine the levels of plasma M-CSF in cervical cancer patients and cervical intraepitheliai neoplasia(CIN)patients,and to discuss the diagnostic utility of M-CSF in the development of cervi-cal cancer. Methods Forty-nine cases of cervical cancer,60 cases of CIN and 40 healthy controls were selected from June 2014 to June 2016. Plasma levels of M-CSF and SCC-Ag were determined by using ELISA and MEIA, respectively. Results Significantly different concentrations of M-CSF and SCC-Ag were observed in patients with cervical cancer compared to the healthy controls and CIN patients(P<0.01,respectively). Significant difference in plasma M-CSF level between the healthy controls and benign lesion patients were also found(P<0.05).However, no significant difference in SCC-Ag was found between the healthy controls and benign lesion patients. SCC-Ag combined M-CSF could obviously increase the detection rate of cervical cancer,without increasing the false posi-tive rate. The level of M-CSF in patients with cervical cancer and high grade of CIN reduced to the normal level, with significant difference before and after surgery(P<0.05).Meanwhile,the level of SCCAg in CIN patients was significantly reduced before and after surgery(P<0.05).Conclusions This study suggests the potential utility of M-CSF as a good candidate for a serum marker of cervical cancer,as well as benign lesions of this organ(CIN), and M-CSF may also be use to predict the outcome of CIN.
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Objective:To confirm the effects of the macrophages and NO in the fibrosis formation of transplanted kidneys with chronic rejection. Methods:The quantitive immunohistochemistry was employed to observe the changes of relative quantitiy of macrophages, NO, collagen Ⅲ andⅣ, and to reveal the association between the increases of macrophages, NO, histopathologic damages, deposition of collagen Ⅲ and Ⅳ, finally, to infer the roles of the macrophages and NO in the fibrosis formation of transplanted kidneys with chronic rejection. Results: The macrophages accumulated and increased in the glomeruli, the tubules and the intersiticia tissue of kidneys, which was companied by the increased expression of collagen Ⅲ and Ⅳ during the early and middle stages. However, the macrophages and NO could not be detected, which was companied by the decreased deposition of collagen Ⅲ and Ⅳduring the advanced stage. There were significant differences between the 3 types(glomerulus disease type,blocking vessel type and intersticial sclerostic type) (P<0.05 or P<0.01). Conclusion:The increase of macrophages and the NO may closely interrelated with the fibrosis formation in transplanted kidneys with chronic rejection.
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PURPOSE To investigate the relationship between the changes of extracellular matrix invaded by colorectal carcinoma and vascular endothelial cells,which will be useful to understand colorectal carcinoma biological behavior and may have clinical significance in the treatment of colorectal carcinoma.METHODS Immunohistochemistry technique and semi quantitative analysis were used.RESULTS As to the changes of ECM and endothelial cells,there were significant differences among the paracarcinoma groups,different invasive groups and normal group.THe increase of LN,CD34,F8 and actin were correlated with colorectal carcinoma invasion( P
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Flow cytometry analysis of DNA ploidy level and S-phase fraction (SPF) was carried out in 24 snap-forzen tissue specimens of ovarian carcinoma. The relationship of DNA ploidy level and SP-F with age,clinical stage, ascites, histologic type,pathological grade,lymphocyte infiltration and psammoma bodies was analyzed.Results showed that the relationship of DNA ploidy level and SPF with ascites and pathological grade was significant. Aneuploid portion and SPF in patients with ascites or pathological grade Ⅲ or Ⅱ were higher than those in patients with no ascites or pathological grade I. The author considers that DNA ploidy level and SPF of ovarian carcinoma can serve as a relatively independent objective index which reflects tumor's biological behaviours,and will be of great auxiliary value to early diagnosis and therapy of ovarian carcinoma.
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In this study, two experimental patterns of autogenous nerve replantation in situ and centrocentral nerve simple suture were performed on the rabbit median and ulnar nerves. By light and transmission electron microscopy and immunohistochemistry, the results showed that autogenous nerve replantation in situ could inhibit neuroma formation, and its mechanism might that two proximal stump axons could conjunct within interpolated graft segment, and the nerve simple suture could not inhibit neuroma development for lack of proper environment for conjunction of two proximal stump axons.