Enfermedad oncoproliferativa en el receptor de trasplante renal. Nuestra experiencia / Oncoproliferative diseases in kidney transplant recipients. Our experience

Introducción: El cáncer conlleva a una mortalidad de hasta 12 % en los pacientes trasplantados, y se considera la tercera causa de morbilidad y mortalidad en los receptores, al ser estos susceptibles a desarrollar enfermedades oncoproliferativas, a largo plazo. Objetivo: Describir la incidencia de neoplasias en receptores de trasplante renal. Métodos: Estudio descriptivo y longitudinal que incluyó 15 receptores de trasplante renal funcionante, con diagnóstico de neoplasias malignas en diferentes localizaciones en el período comprendido entre enero de 2017 y junio de 2023 en el servicio de Nefrología del Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro» de Santa Clara, Villa Clara. Resultados: Predominaron los hombres y el color de piel blanca: 53,3 % y 73,3% respectivamente, con tiempo postrasplante superior a tres años en 12 pacientes (80 %). El antecedente de exposición al citomegalovirus representó el 80 %; la infección bacteriana de la vía respiratoria y digestiva fue la más frecuente. Conclusiones: La neoplasia intraepitelial cervicouterina, la de colon con metástasis hepática y las cerebrales resultaron las más frecuentes, y fueron tratadas con cirugía, quimioterapias o ambas, según los criterios quirúrgicos en cada caso; no obstante, la mortalidad fue elevada. La estirpe neoplásica preponderante fue la neoplasia intraepitelial cervical en un 26,6 %. La mortalidad fue alta y la supervivencia fue menor en el sexo masculino, sin rebasar los dos años posteriores al diagnóstico.

Introduction: cancer entails a mortality of up to 12 % in transplanted patients and is considered the third leading cause of morbidity and mortality in recipients who are susceptible to develop oncoproliferative diseases in the long term. Objective: to describe the incidence of neoplasms in renal transplant recipients. Methods: we carried out a descriptive and longitudinal study including 15 functioning renal transplant recipients who were diagnosed with malignant neoplasms in different locations in the Nephrology service at "Arnaldo Milián Castro" Clinical and Surgical University Hospital in Santa Clara, Villa Clara between January 2017 and June 2023. Results: males and white skin color predominated: 53.3 % and 73.3% respectively, with post-transplant time greater than three years in 12 patients (80 %). The history of cytomegalovirus exposure represented 80 %; bacterial infection of the respiratory and digestive tracts was the most frequent. Conclusions: cervicouterine intraepithelial neoplasia, colon cancer with liver and brain metastases were the most frequent and treated with surgery chemotherapies or both according to the surgical criteria in each case; however, mortality was elevated. Cervical intraepithelial neoplasia predominated in a 26.6 %. Mortality was high and survival was lower in males, without exceeding two years after the diagnosis.

Comparison of tube method versus gel method for the results of blood group IgM antibody titration in ABO-incompatible kidney transplant recipients / 中华器官移植杂志

Objective:To explore the critical value of different blood group antibody titration in ABO blood group incompatible kidney transplant(ABOi-KT)recipients by tube and gel methods to provide rationales for selecting the threshold value of antibody titration before ABOi-KT.Methods:From January 2019 to April 2021, 681 blood group antibody titrations were performed for 214 ABOi-KT recipients.There were type A( n=135), type B( n=168)and type O( n=378). The difference, correlation and consistency of two methods were statistically analyzed. Results:Tube method was 2 gradients lower than gel method(4-fold dilution)and the results were significantly different( P<0.000 1). Spearman's test indicated that the results of two methods were significantly correlated( P<0.000 1). The results of intraclass correlation coefficient showed that the consistency of two methods was general for type A recipients(ICC=0.640), decent for type B recipients(ICC=0.751)and poor for type O recipients(ICC<0.4). When the critical value of tube method was set, titration of type A anti-B was 16, titration of type B anti-A 8 and titration of type O anti-A/B 8.And the corresponding critical values of gel was type A anti-B 32, type B anti-A 16 and type O anti-A/B 16. Conclusions:The results of ABO blood group IgM antibody titration by gel and tube methods are correlative.And gel method is recommended for more stable and reproducible results.

Impacto de la bacteriuria asintomática en trasplante renal. cohorte retrospectiva / Impact of asymptomatic bacteriuria on renal transplantation. retrospective cohort study

RESUMEN Introducción: La bacteriuria asintomática (BA), en el primer año postrasplante renal,tiene una incidencia mayor al 50%. La infección urinaria (ITU) es la complicación infecciosa más común en trasplante renal, su incidencia oscila entre el 30 y el 70% en el primer año.Objetivo:Analizar la incidencia de ITU y BA en el primer año postrasplante renal y su impacto en la función renal. Material y métodos: Estudio retrospectivo, de pacientes trasplantados renales, mayores de 18 años, en el período comprendido entre enero de 2006 y diciembre de 2017, en nuestro centro. Fueron excluidos pacientes con trasplantes renales combinados, pérdida del injerto renal durante el primer año por complicaciones quirúrgicas (trombosis, rotura renal) o médicas (rechazo, recidiva de enfermedad de base).Resultados: Fueron analizados 161 pacientes adultos trasplantados renales. La incidencia en el primer año postrasplante de ITU y BA fue del 32% y del 25%, respectivamente. La función renal promedio al año del trasplante fue: de los pacientes con ITU(n=53) Cr 1,36(±0,44), de los pacientes con BA no tratada(n=30) Cr 1.36(±0,41), de los pacientes con BA tratada(n=11)Cr 1,39(±0,42), y de los pacientes sin ITU ni BA(n=90) Cr 1,31(±0,43) p=0,95. El riesgo de ITU en las BA no tratadas fue del 55% y en las tratadas del 57%, con un RR 0,96 (IC 95% 0,52-1,8). Conclusión: No hubo diferencias significativas en la función renal al año del trasplante en los pacientes que tuvieron ITU y BA en relación a los pacientes que no tuvieron. El tratamiento de las BA no redujo el riesgo de padecer ITU.

ABSTRACT Introduction:Asymptomatic bacteriuria (AB) during the first year post-renal transplantation has an incidence higher than 50%. Urinary tract infection (UTI) is the most frequent complication of renal transplantation; its incidence is between 30 and 70 % during the first year. Objective: To analyze the incidence of UTI and AB during the first year post-renal transplantation and their impact on renal function. Methods: Retrospective study in renal transplantation patients older than 18 between January 2006 and December 2017 in our center. Patients who had received combined renal transplantation, lost renal graft during the first year due to surgical complications (thrombosis, allograft rupture) or medical complications (rejection, underlying disease recurrence) were excluded. Results: A study was performed with 161 adult patients who had undergone kidney transplantation. The incidence of UTI and AB during the first year after receiving transplantation was 32% and 25%, respectively. The mean renal function one year after transplantation was as follows: (n=53) Cr 1.36(±0.44) for UTI patients; (n=30) Cr 1.36(±0.41) for AB non-treated patients; (n=11) Cr 1.39(±0.42) for AB treated patients, and (n=90) Cr 1.31(±0.43) p=0.95 for patients not suffering from UTI or AB. The risk of UTI was 55 % for non-treated AB and 57% for treated AB, with RR 0.96 (95% CI: 0.52-1.8).Conclusion: No significant differences in renal function were found in UTI and AB patients one year after transplantation as compared to patients not suffering from these conditions. AB treatment did not reduce UTI risk.

Treatment of chronic hepatitis C in patients with chronic kidney disease with Sofosbuvir-basead regimes

ABSTRACT Background: To analyze the effectiveness and the safety of Sofosbuvir-based regimens to treat patients with chronic hepatitis C virus (HCV) infection and chronic kidney disease (CKD). Methods: A retrospective, observational study in patients with chronic HCV infection and CKD treated with Sofosbuvir-based regimens was performed. Liver fibrosis, comorbidities, HCV genotype and sustained virological resposnse (SVR) at 12th week post-treatment were evaluated. Kidney function was accessed by serum creatinine and glomerular filtration rate (GFR). The assumed level of significance was 5 %. Results: Thirty-five patients were treated. The mean age was 52.1 ± 10.9 years, 19 (54.3 %) were women, 32 (91.4 %) were already kidney transplanted and 3 (8.6 %) were on hemodialysis. The SVR by intention to treat was 88.6 %. The mean GFR was 65.8 ± 28.6 and 63.7 ± 28.3 ml/min pre- and post-treatment respectively (p > 0.05). Treatment was interrupted in 1 (2.85 %) patient due to anemia and in 2 (5.7 %) due to loss of kidney function. Conclusion: Sofosbuvir-based regimens are effective to treat HCV in patients with CKD. In patients with mild CKD this type of therapy seems to be safe.

Application of multiplex PCR assay to study early multiple herpesviruses infection during HSCT / 中华血液学杂志

Objective: To investigate herpesvirus infection in early stage of hematopoietic stem cell transplantation (HSCT) by multiplex polymerase chain reaction (PCR), and to explore the association between multiple herpesviruses infection and clinical characteristics in HSCT patients and its impact on post-transplant complications and prognosis. Methods: A total of 734 peripheral blood samples were collected from 90 patients undergoing HSCT in the Department of Hematology, the First Affiliated Hospital of Soochow University between February 2017 and August 2017. The peripheral blood specimens were obtained before and within 90 days after transplantation at different time points. Lab-Aid824 Nucleic Acid Extraction Mini Reagent was used to extract DNA and multiplex PCR assay was used to simultaneously detect 8 kinds of human herpesviruses from genomic DNA. The incidence of various herpesvirus infections, its correlation with clinical features and effects on post-transplant complications and prognosis were analyzed. Results: The median follow-up time was 192 (range: 35-308) days. Among the 90 patients before transplantation, the incidence of herpes virus infection was 35.6% (32/90), including 12.2% (11/90) with one herpes virus infection and 23.3% (21/90) with multiple viruses infection. The incidence of herpes virus infection after transplantation was 77.8% (70/90), including 20.0% (18/90) with one herpes virus infection and 57.8% (52/90) with multiple herpes virus infection. Among the 52 patients with multiple herpes viruses infection, 30 (57.7%) patients were infected by 2 kinds of viruses, 18 (34.6%) patients by 3 kinds of viruses and 4 (7.7%) patients by 4 kinds of viruses. There was a correlation between HHV-6 and HHV-7 herpesvirus infection (OR=13.880, Q=0.026). EBV infection was related to HHV-7 infection (OR=0.093, Q=0.044). The age of patients was correlated with the incidence of HHV-1 infection before transplantation. There were 24 patients in our study experienced clinical symptoms associated with viral infection. The main manifestations were hemorrhagic cystitis (HC), interstitial pneumonia, enteritis, viral encephalitis and fever of unknown origin. EBV infection was related to HLA incompatibility and the inconsistent of the ABO blood group and grade Ⅱ-Ⅳ aGVHD after transplantation. HLA incompatibility and the unrelated donor and grade Ⅱ-Ⅳ aGVHD were related to multiple viruses infection. Conclusion: Multiple herpesviruses were common in patients undergoing HSCT, which were closely related to HLA mismatch, unrelated donor and grade Ⅱ-Ⅳ aGVHD.

Application of multiplex PCR assay to study early multiple herpesviruses infection during HSCT / 中华血液学杂志

Objective@#To investigate herpesvirus infection in early stage of hematopoietic stem cell transplantation (HSCT) by multiplex polymerase chain reaction (PCR), and to explore the association between multiple herpesviruses infection and clinical characteristics in HSCT patients and its impact on post-transplant complications and prognosis.@*Methods@#A total of 734 peripheral blood samples were collected from 90 patients undergoing HSCT in the Department of Hematology, the First Affiliated Hospital of Soochow University between February 2017 and August 2017. The peripheral blood specimens were obtained before and within 90 days after transplantation at different time points. Lab-Aid824 Nucleic Acid Extraction Mini Reagent was used to extract DNA and multiplex PCR assay was used to simultaneously detect 8 kinds of human herpesviruses from genomic DNA. The incidence of various herpesvirus infections, its correlation with clinical features and effects on post-transplant complications and prognosis were analyzed.@*Results@#The median follow-up time was 192 (range: 35-308) days. Among the 90 patients before transplantation, the incidence of herpes virus infection was 35.6% (32/90), including 12.2% (11/90) with one herpes virus infection and 23.3% (21/90) with multiple viruses infection. The incidence of herpes virus infection after transplantation was 77.8% (70/90), including 20.0% (18/90) with one herpes virus infection and 57.8% (52/90) with multiple herpes virus infection. Among the 52 patients with multiple herpes viruses infection, 30 (57.7%) patients were infected by 2 kinds of viruses, 18 (34.6%) patients by 3 kinds of viruses and 4 (7.7%) patients by 4 kinds of viruses. There was a correlation between HHV-6 and HHV-7 herpesvirus infection (OR=13.880, Q=0.026). EBV infection was related to HHV-7 infection (OR=0.093, Q=0.044). The age of patients was correlated with the incidence of HHV-1 infection before transplantation. There were 24 patients in our study experienced clinical symptoms associated with viral infection. The main manifestations were hemorrhagic cystitis (HC), interstitial pneumonia, enteritis, viral encephalitis and fever of unknown origin. EBV infection was related to HLA incompatibility and the inconsistent of the ABO blood group and grade Ⅱ-Ⅳ aGVHD after transplantation. HLA incompatibility and the unrelated donor and grade Ⅱ-Ⅳ aGVHD were related to multiple viruses infection.@*Conclusion@#Multiple herpesviruses were common in patients undergoing HSCT, which were closely related to HLA mismatch, unrelated donor and grade Ⅱ-Ⅳ aGVHD.

Two-stage technique in third molar autotransplantation: case report / Técnica de dois estágios no autotransplante de terceiro molar: relato de caso

ABSTRACT Tooth autotransplantation is an option for treating patients presenting early tooth loss. The teeth most commonly removed are the first molars, and their absence could lead to several oral health problems in patients. This transplant technique consists of the transposition and repositioning of a tooth from one area to another, in the same patient. Dental implants have high success rates, but tooth autotransplantation is less complex and less expensive, because the patient's own tooth is used. In the context of dental rehabilitation, tooth transplantation is focused on re-establishing masticatory function and esthetics. Success rates are variable, but in the majority of cases they exceed 80%. This article aims to report the case of a patient who underwent autotransplantation of the maxillary left third molar into the maxillary right first molar position. The surgical procedure was performed on two stages. After a 3-year clinical and radiographic follow-up period, a satisfactory result was achieved with the transplanted tooth presenting a healthy pulp and periodontal tissues, reestablishing the patient's function and esthetics.

RESUMO O transplante dentário autógeno (autotransplante dentário) é uma opção de tratamento para pacientes que perdem dentes precocemente. Os elementos mais comumente extraídos são os primeiros molares permanentes e a falta dos mesmos pode acarretar em diversos agravos para a saúde bucal do paciente. O autotransplante dentário consiste na transposição cirúrgica e reposicionamento de um elemento dentário, de um local da boca para outro, no mesmo indivíduo. O tratamento com implantes possui elevado índice de sucesso, mas o transplante apresenta maior praticidade e menor custo, uma vez que utiliza um órgão do próprio paciente. Assim, como a reabilitação protética, tem como função o restabelecimento da mastigação e estética. As taxas de sucesso são variáveis, mas em sua maioria ultrapassam os 80%. O presente trabalho relata o caso clínico de uma paciente submetida ao transplante do germe dental do elemento 28 para o alvéolo do elemento 16. O ato cirúrgico foi realizado com a técnica de dois estágios e após o acompanhamento clínico e radiográfico de três anos, obteve-se um resultado satisfatório e o elemento transplantado apresentou saúde pulpar e periodontal, restabelecendo a função e a estética à paciente.

The treatment of tendon injury / 医学研究生学报

Multitudinous therapeutic options of tendon damage have been carried out , and in this paper , we will introduce several methods including suture , tendon transplantion , growth factors , stem cells and genes , alone or in combination .The classic su-ture methods, such as MK and K+R methods, have been already mature , and the new suture bridge can also present good strength and biological property.Recent years, the freezing method improves the immunoreaction in tendon transplantion .Furthermore, using the growth factors and stem cells alone or combined can improve the repair of tendon .The genes therapy can upregulate the growth factors to repair the injured tendon by transfecting adenovirus into the tissues of animals .

A method of establishing orthotopic transplantable hepatocellular carcinoma in mice / 肿瘤研究与临床

Objective To establish a method for preparing orthotropic transplantable hepatocellular carcinoma in mice. Methods According to the liver detailed anatomical structure of the mouse, 50 μl mouse ascites containing 1 ×106 and 5 ×105 mouse hematoma H22 cells was input to liver in 12 Kunming mice through percutaneous intraperitoneal injection by syringe, respectively, to establish orthotopic transplantable hepatocellular carcinoma model. The growth status of mice was observed, and the pathological changes of liver and tumor metastasis tissues were detected. The tumor formation and metastasis were analyzed. Results The tumor formation rate was 100% (12/12) by direct injection of mouse hematoma H22 cells in 2 groups. The inoculated mice started to appear ascites at the 6th day, and all mice produced ascites at the 10th day. The survival time was (16.17 ±3.07) d and (18.08 ±3.34) d in 1 ×106 group and 5 ×105 group, respectively. Some mice emerged tumor metastasis in kidney, intestine, spleen and mesenteric lymph nodes. Conclusion The method of direct injection could establish orthotropic transplantable hepatocellular carcinoma model in mice, which can be used for antitumor drug research.

Long-term clinical efficacy of simplified multivisceral transplantation from donation after citizen's death / 中华器官移植杂志

Objective To investigate the long-term clinical efficacy of simplified multivisceral transplantation in patients with end-stage liver disease and type 2 diabetes.Methods The clinical data of 31 cases of simplified multivisceral transplantations between 2009 to 2017 were retrospectively analyzed.Results Median post-transplant follow-up was currently 13 ± 26 (0-86) months.Two recipients died of multiple organ dysfunction system (MODS) followed by severe sepsis on postoperative day (POD) 15 and 18,respectively.One recipient died from severe pneumonia with pyemia on POD 37.One recipient died of graft versus host disease (GVHD) on POD 40.One recipient died from acute myelogenous leukemia.Two recipients died of tumor recurrence at postoperative month (POM) 9 and 26,respectively.No biliary complication or diabetes recurrence was observed during follow-up.Condusion Donation after citizen's death is becoming the only organic source in China.Our results indicate that combined en-bloc liver-pancreas transplantation is technically feasible and leads to excellent long-term control of glucose metabolism and satisfactory quality of life in recipients with end—stage liver disease and diabetes mellitus.

Classification of ureteral stenosis after renal transplantation and evaluation of treatment in 9 cases / 中华器官移植杂志

Objective To evaluate the clinical feasibility of grading of ureteral stricture in renal allograft.Methods The clinical data of 9 case of ureteral stricture after renal transplantion from February 2015 to September 2015 were retrospectively analyzed and relative articles were reviewed to evaluate the significance of ureteral stricture grading.The diagnosis of ureteral stenosis was made by serum creatinine elevation,ultrasound of allograft kidneys and presence of stricture on a pyelogram.Grade 1 ureteral stenosis was defined as graft function deterioration with presence of hydronephrosis on ultrasound,but no obvious stricture identified on a pyelogranm.Grade 2 was defined as serum creatinine elevation,presence of hydronephrosis on ultrasound,and a focal (＜1 cm) distal ureteral stricture at the ureteral anastomotic site on a pyelogram.Grade 3 was defined as serum creatinine elevation,hydronephrosis on ultrasound,and a long segment (＞1 cm) distal ureteral stricture extending to proximal ureter or pelvis on pyelogram.Results One case,6 cases and 2 cases were classified to grade 1,2 (stricture length ＜1 cm) and 3 (＞1 cm),respectively.One case of grade 1,6 cases of grade 2 and 1 case of grade 3 were successfully dilated by balloon dilation catheter and endoureterotomy.One case of grade 3 was converted to open reconstructive surgery.Surgery success rate of grade 1 and 2 was 100％ (7/7) and 100％ (6/6) 6 and 9 months after surgery,respectively.Ureteral stenosis did not recur in one case of grade 1 and 6 cases of grade 2 during a follow-up period of 12 months after surgery.However,one case of grade 3 reoccurred 6 months after surgery,and reoperation was performed and there was no recurrence up to now (10 months).Conclusion Wuzhi tablet acted as an effective agent that makes rifampicin containing anti-tuberculosis chemotherapy possible and safe by stabilizing blood concentration of tacrolimus in post-renal transplant tuberculosis patients,which also reduced the dosage of tacrolimus as well as the risk of acute rejection greatly.

Bone marrow mesenchymal stem cell transplantation via different approaches in treatment of liver cirrhosis in mice / 临床肝胆病杂志

ObjectiveTo investigate the clinical effects of bone marrow mesenchymal stem cell (BMSC) transplantation via different approaches in the treatment of liver cirrhosis in mice. MethodsA total of 46 BALB/c mice were randomly divided into normal control group with 5 mice and liver cirrhosis model group with 41 mice. Subcutaneously injected carbon tetrachloride olive oil was used to establish the mouse model of liver cirrhosis. A total of 36 mice with liver cirrhosis were randomly divided into control group, caudal vein BMSC transplantation group, and spleen BMSC transplantation group, with 12 mice in each group. Whole bone marrow adherent culture was performed to obtain the third-generation BMSCs, and flow cytometry was used for cell surface identification. BMSCs were injected into the mice through the caudal vein or spleen. Blood samples were collected at 4 weeks after transplantation to measure liver function. HE and Masson staining and α-smooth muscle actin (α-SMA) immunohistochemistry were performed for liver sections. Liver injury and fibrosis in mice were examined. A one-way analysis of variance was used for comparison between groups. ResultsAt 8 weeks after the establishment of the model, the mice in the model group had sparse and dark yellow hair, reduced food consumption and activity, and a reduction in body weight. After transplantation, compared with the model control group, the caudal vein BMSC transplantation group and spleen BMSC transplantation group showed a significant increase in albumin and significant reductions in alanine aminotransferase and aspartate aminotransferase (all P＜0.01). There were no significant differences between the two transplantation approaches (P＞0.05). After transplantation, there were significant changes in diseased tissue, alleviated liver cirrhosis, reduced collagen fiber and necrotic area, and a good structure. Immunohistochemistry showed both transplantation groups showed significant reductions in the number of cells with positive α-SMA. ConclusionBMSC transplantation via the tail vein or spleen can improve liver function and diseased tissue in mice with liver cirrhosis and these two approaches have comparable clinical effects.

Periopertive nursing of five children with floating thumb treated with composite tissue flap grafting / 现代临床护理

Objective To summarize experience of periopertively nursing children with floating thumb treated with composite tissue flap transplantation. Method Health education was done to 5 children with floating thumb treated with composite tissue flap grafting as well as their families including preparing preoperational checks, preventing crisis of blood circulation, medication and pain nursing and paying attention to rehabilitation instruction. Result All thumbs survived successfully and one patient developed with crisis of blood circulation, which disappeared in 15 minutes. Conclusion Good preoperative nursing and effective health instruction are critical for nursing of the children with floating thumb treated with composite tissue flap transplantation.

Therapeutic effect of splenic autologous transplantation on rat liver cancer induced by DEN / 局解手术学杂志

Objective To investigate the therapeutic effect of autologous transplantation of spleen on rat liver cancer induced by DEN. Methods Forty rats were randomly divided into A and B group on average. Total spleens of 40 rats were resected, which preserved in liquid nitrogen. All splenectomy rats were feeded with DEN to induce hepatocellular carcinoma. After 12 weeks ,all rats which had were successfully induced liver cancer were transplanted by autologous spleen in group A. Group B were sham operation as control. Results Survival period was significantly higher in group A than that in group B. But transplanted splenic tissue had not recovered to normal morphological structure until these rats died. Conclusion Autologous transplantation of spleen has therapeutic effect for liver cancer induced by DEN.

Correlation between miR-494 and TH17 cell differentiation in murine cardiac transplant rejection / 中华器官移植杂志

Objective To investigate correlation between microRNA (miR-494) and TH 17 cell differentiation in murine cervical heterotopic cardiac transplant model.Method The heterotopic cardiac transplant models of Balb/c→C57BL/6 mice were established as experimental group,and those of C57BL/6→C57BL/6 mice as control group.Real time-polymerase chain reaction(PCR) was used to detect miR-494 and interleukin(IL)-17A mRNA expression in the grafts.CD4+ T cells,CD8+ T cells and CD45+ myeloid cells were isolated from the grafts,and miR-494 and IL-17 mRNA expression was detected.In vitro,lymphocytes in the spleen from C57BL/6 mice were harvested,and CD4+ T cells were isolated with MACS and then stimulated to TH 1,TH 2,TH 17,Treg subset cells.The expression of IL-17A mRNA and miR-494 in different T subsets was examined by Reverse transcription-polymerase chain reaction(RT-PCR).Result Two grafts from each study group were harvested on the 7th day post-transplantation.In experimental group,the IL-17A mRNA expression was increased,while the expression of miR-494 was decreased as compared with control group with the difference being significant between two groups.The expression of IL-17A rnRNA in CD4+ T cells of the grafts was significantly increased,while that expression of miR-494 was decreased.In vitro,the expression of miR-494 in TH 17 cells was significantly lower than that in TH 1,TH 2 and Treg cells.Conclusion miR-494 is related closely to TH 17 cells differentiation in the transplant rejection,which may play a role in transplant rejection through regulating TH 17 cells.

Veno-arteriolization in the field of hand surgery successful expansion / 国际外科学杂志

Objective To explore the clinical effect of Veno-arteriolization in digit replantation and reconstruction and transplantation of flap.Methods All clinical data of 49 cases of vascular special conditions were divide which received surgical treatment,21 cases in replantation group,5 cases in reconstruction group,23 cases in transplantation of flap group.All patients underwent veno-arterionlization.Results Two cases necrosis in transplantation of flap group,all the other fingers survived uneventfully.The patients were followed up for (4.5 ± 0.6)months.The outcome was satistactory both functionally and cosmetically in replantation and reconstruction groups.2-PD was (9.5 ±0.5) mm in replantation group,2-PD was (10.5 ± 1.0) mm in reconstruction group.The flaps had excellent appearance,good texture and color match in transplantation of flap group.According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975,the results of this series showed excellent in 42 cases,good in 5 cases and fair in 2 cases,the excellent and good rate was 95.9％.Conclusions Veno-arteriolization was a new method for hand surgery trauma in specially circumstances.Owing to its simple procedure,reliable effect,it worth to be spreading.

Chemotherapy combined with infusion related HLA-mismatched hematopoietic stem cells for hematologic malignancies: a novel therapeutic strategy / 白血病·淋巴瘤

Objective To investigate the therapeutic outcomes of chemotherapy with infusion related HLA-mismatched hematopoietic stem cells for hematologic malignancies.Methods Therapy responses and hematopoietic recovery as well as complications of 9 patients were analyzed.Results In the 9 patients aged 29-67 years,four were acute myeloid leukemia,one was acute B lymphocytic leukemia,two were multiple myeloma,one was Hodgkin' s disease,one was diffuse large B cell lymphoma.The average of MNC was (3.12±1.29)×108/kg,CD34+ cells was (1.71±1.00) ×106/kg,and CD3+ cells was (2.13 ±0.99) ×108/kg.There was complete remission in four patients,partial remission in one,disease progression in four.Following up 2 to 14 months,four patients were in survival.No donor chimerism was detected and no graft-versus-host disease was observed in any patient.Conclusion Chemotherapy with infusion related HLA-mismatched hematopoietic stem cells for hematologic malignancies may provide a promising treatment method as a novel therapeutic strategy.

Diagnostic value of immediate early antigen-mRNA in the diagnosis of cytomegalovirus infection after kidney transplantation / 中国综合临床

Objective To investigate the diagnostic value of the immediate early antigen(IE) mRNA by nucleic acid sequence-based amplification(NASBA) in peripheral blood cytomegalovirus (CMV) infection,and to establish and promote the diagnosis method for CMV.Methods Five to seven ml blood was taken from 32 patients at 3 week and 7 week after renal transplantation to detect serum cytomegalovirus antigen and antibody expression by NASBA,Real time-PCR and enzyme-linked immunosorbent assay (ELISA) sensitivity and specificity were compared.Results The results of CMV detection in 32 renal transplanted patients respectively showed that the positive rate of peripheral blood IE-mRNA by NASBA was 45.8％ (15/32) ;The positive rate of HCMV-DNA in blood by Real time-PCR was 45.8％ (15/32).Using ELISA,the positive rate of HCMV-(IgG +IgM) was 37.5％ (14/32).IE-mRNA and HCMV-DNA had higher sensitivity and specificity and lower false positive rate than HCMV-(IgG +IgM).The positive rates of IE-mRNA by NASBA,Real time-PCR and ELISA were 92.8％,71.5％ and 42.8％ respectively in the 14 cases.Conclusion The nucleic acid amplification method (NASBA based sequence) and Real time-PCR are sensitive,rapid diagnosis methods of HCMV infection,with higher sensitivity and specificity and lower false positive rate than traditional ELISA.And NASBA detection of IE-mRNA has good value for auxiliary clinical diagnosis.

Proximal femoral autograft for pelvic reconstruction after tumor resection / 中华骨科杂志

Objective To investigate technique and indications of proximal femoral autograft for pelvic reconstruction after tumor resection.Methods Between October 2006 and May 2011,5 patients with primary malignant pelvic tumor underwent tumor resection,pelvic reconstruction by proximal femoral autograft,and hip reconstruction by tumor prosthesis.There were 3 males and 2 females,aged from 19 to 55years (average,30.6 years).There were 3 cases of chondrosarcoma and 2 cases of primitive neuroectodermal tumor (PNET).The tumor involved zone Ⅰ and zone Ⅱ in 3 cases,and zone Ⅱ and zone Ⅲ in other 2cases.All 5 patients were followed up,and complications,MSTS (Musculoskeletal Tumour Society) score and prognosis were recorded.Results At final follow-up,one patient died of pulmonary metastasis,one patient survived with local recurrence,and other 3 patients survived without recurrence.The complications consisted of local recurrence,prosthesis loosening,nonunion,infection,and sciatic nerve palsy.One patient underwent revision surgery for prosthesis loosening 26 months after the initial operation.One patient underwent amputation for local recurrence 6 months after the initial operation.The average MSTS score was 19.2.Conclusion Proximal femoral autograft is an effective method for pelvic reconstruction after tumor resection,which can be used for defect in zone Ⅱ and zone Ⅲ,as well as in zone Ⅰ and zone Ⅱ.However,the method has a high rate of complications.The short-term result is similar to that of pelvic prosthesis,while the long-term result needs further observation.

Effect of Xiaozheng Yiliu Decoction on the cytotoxic activity of cisplatin against human ovarian cancerOVCAR/DDP cells and its action mechanism / 肿瘤研究与临床

Objective To study the cytotoxic activity of Chinese compound prescription (Xiaozheng Yiliu Decoction) combined with cisplatin on human ovarian cancer OVCAR/DDP cells and its molecular mechanism. Methods The xenograft model was established by injection of OVCAR/DDP cells. Forty nude mice were randomly allocated into four groupsincluding control group, cisplatin treatment group, low-dose Xiaozheng Yiliu plus cisplatin treatment group,and high-dose Xiaozheng Yiliu plus cisplatin treatment group.The apoptosis was determined by TUNEL analysis.The survivin expression was detected by RT-PCR analysis.Results The inhibit rates in cisplatin treatment group, low-dose Xiaozheng Yiliu plus cisplatin treatment group,and high-dose Xiaozheng Yiliu plus cisplatin treatment group,were(5.56±1.14) ％,(18.42±7.73) ％,and (31.59±12.58) ％,respectively,and there were significant differences among the groups(F=8.64,P＜0.01 ).The TUNEL analysis showed that the percentages of cell apoptosis were(2.35±1.04) ％,(4.56±1.61) ％,(12.42±3.68) ％,(21.59±5.17) ％ in four different groups,respectively.After treated by Xiaozheng Yiliu Decoction,the mRNA expression of survivin was found to be down-regulated by RT-PCR analysis. Conclusion Xiaozheng Yiliu Decoction could iucrease the cytotoxic activity of cisplatin on ovarian cancer OVCAR/DDP cells, which may be related to the down-regulation of survivin gene expression.