Preliminary experience of robotic-assisted kidney transplantation in a single center / 器官移植

<b>Objective</b> To evaluate the safety, effectiveness and feasibility of robotic-assisted kidney transplantation (RAKT). <b>Methods</b> Clinical data of 16 patients who underwent kidney transplantation were collected. Among them, 8 recipients received RAKT (RAKT group) and 8 cases underwent open kidney transplantation (OKT) with the contralateral kidney from the same donor (OKT group). Perioperative status and the recovery of renal allograft function were compared between two groups. <b>Results</b> All patients successfully completed the surgery. In the RAKT group, no patient was converted to open surgery. The operation time in the RAKT group was longer than that in the OKT group (<i>P</i>=0.015). No significant differences were observed in the serum creatinine levels before surgery and upon discharge between two groups (both <i>P</i>>0.05). In the OKT group, one recipient developed delayed graft function (DGF), and the remaining recipients did not experience perioperative complications. No significant difference was noted in the short-term recovery of renal allograft function between two groups (<i>P</i>>0.05). <b>Conclusions</b> Postoperative recovery of the recipients in the RAKT group is equivalent to that of their counterparts in the OKT group. RAKT is a safe and effective procedure for the team expertise in kidney transplantation.

A suspected case of hemorrhagic fever with renal syndrome complicated with dengue fever in Longhua District, Shenzhen / 中华地方病学杂志

Objective:To investigate and analyze a suspected case of hemorrhagic fever with renal syndrome (HFRS) complicated with dengue fever (DF) in Longhua District of Shenzhen City, so as to improve the level of diagnosis and monitoring of such case.Methods:The morbidity and treatment data of this case were analyzed retrospectively, and the results of blood routine, urine routine, dengue virus and Hantavirus antibody, nucleic acid test and other laboratory tests were collected, the epidemiological analysis included the history of travel, mosquito bite and rodent contact was did.Results:This case was 25-year-old male presented with fever (maximum body temperature 39.4 ℃), chills and fatigue. On the 5th day, he developed oliguria. The clinical laboratory results showed that the platelet count decreased, the urine routine was detected, and the sediment tube type was 86.32 μl. The serum samples were tested, positive for dengue virus NS1 antigen and IgM antibody, negative for viral nucleic acid; positive for IgM antibody of Hantavirus, positive for Hantavirus nucleic acid. This case had a history of contact with mice without any protection, no obvious epidemiological history of DF, this patient might be a suspected case of HFRS with DF.Conclusions:This patient may be a suspected case of HFRS with DF. The infectious source of HFRS is suspected to be rats.

Clinicopathologic characterization of malignant mixed tumor of the skin accompanied by eccrine porocarcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic features, immunophenotype, pathological diagnosis and treatment of malignant mixed tumor (MMT).@*Methods@#Clinical and pathological features including immunohistochemical phenotypes were analyzed in a case of MMT accompanied with eccrine porocarcinoma (EP) involving both hands, diagnosed definitely in January 2018 along with review of relevant literature.@*Results@#A 64-year-old man presented with multiple rash on both hands for 4 years. Three lesions of 0.5 to 2.2 cm were removed for pathological evaluation. The pathological changes on little finger of left and right hands were MMT with EP, whereas that removed from the right ring finger was EP. MMT showed infiltrative growth with vascular wall invasion and consisted of epithelial (glandular or tube differentiation) and mesenchymal components (mucinous and/or cartilage stroma). The endothelial cells showed moderate to severe cytological atypia, nuclear pleomorphism and increased mitotic activity. The glandular component had histological characteristics of syringocarcinoma with moderately atypical chondrocytes but without myoepithelium. EP was composed of basal cells with visible vacuoles in cytoplasm and the presence of tubular and squamous differentiation, along with obvious atypia. Immunohistochemically cavosurface epithelium of glandular differentiation of MMT showed positivity for CK7, EMA and CD117. Myoepithelium showed S-100, CK5/6 and p63 positivity and stromal cells were positive for S-100. Differential diagnoses included metaplastic carcinoma, malignant myoepithelioma and atypical mixed tumor of skin.@*Conclusions@#MMT with EP is extremely rare.The diagnosis of MMT depends on the morphologic features. Immunohistochemical staining is helpful for differential diagnosis. Surgical excision with safety margins is the treatment of choice. Complementary radiotherapy and/or chemotherapy is still controversial. The clinical course of MMT is deemed unpredictable and long-term follow-up is necessary.

MicroRNAs and immunity in periodontal health and disease / 国际口腔科学杂志·英文版

MicroRNAs (miRNAs) are critical regulators of the host immune and inflammatory response against bacterial pathogens. In the present review, we discuss target genes, target gene functions, the potential regulatory role of miRNAs in periodontal tissues, and the potential role of miRNAs as biomarkers and therapeutics. In periodontal disease, miRNAs exert control over all aspects of innate and adaptive immunity, including the functions of neutrophils, macrophages, dendritic cells and T and B cells. Previous human studies have highlighted some key miRNAs that are dysregulated in periodontitis patients. In the present study, we mapped the major miRNAs that were altered in our reproducible periodontitis mouse model relative to control animals. The miRNAs that were upregulated as a result of periodontal disease in both human and mouse studies included miR-15a, miR-29b, miR-125a, miR-146a, miR-148/148a and miR-223, whereas miR-92 was downregulated. The association of individual miRNAs with unique aspects of periodontal disease and their stability in gingival crevicular fluid underscores their potential as markers for periodontal disease progression or healthy restitution. Moreover, miRNA therapeutics hold great promise for the future of periodontal therapy because of their ability to modulate the immune response to infection when applied in conjunction with synthetic antagomirs and/or relatively straightforward delivery strategies.

Neuroprotective effects of Ginkgo biloba extract and Ginkgolide B against oxygen-glucose deprivation/reoxygenation and glucose injury in a new in vitro multicellular network model / 医学前沿

Acute ischemic stroke (AIS), as the third leading cause of death worldwide, is characterized by its high incidence, mortality rate, high incurred disability rate, and frequent reoccurrence. The neuroprotective effects of Ginkgo biloba extract (GBE) against several cerebral diseases have been reported in previous studies, but the underlying mechanisms of action are still unclear. Using a novel in vitro rat cortical capillary endothelial cell-astrocyte-neuron network model, we investigated the neuroprotective effects of GBE and one of its important constituents, Ginkgolide B (GB), against oxygen-glucose deprivation/reoxygenation and glucose (OGD/R) injury. In this model, rat cortical capillary endothelial cells, astrocytes, and neurons were cocultured so that they could be synchronously observed in the same system. Pretreatment with GBE or GB increased the neuron cell viability, ameliorated cell injury, and inhibited the cell apoptotic rate through Bax and Bcl-2 expression regulation after OGD/R injury. Furthermore, GBE or GB pretreatment enhanced the transendothelial electrical resistance of capillary endothelial monolayers, reduced the endothelial permeability coefficients for sodium fluorescein (Na-F), and increased the expression levels of tight junction proteins, namely, ZO-1 and occludin, in endothelial cells. Results demonstrated the preventive effects of GBE on neuronal cell death and enhancement of the function of brain capillary endothelial monolayers after OGD/R injury in vitro; thus, GBE could be used as an effective neuroprotective agent for AIS/reperfusion, with GB as one of its significant constituents.

The application research about separated bed transfer used in handling orthopedic patients / 中国实用护理杂志

Objective To study the effects about using separated bed transfer to handle orthopedic patients.Methods According to the characteristics of carrying orthopedic patients,separated bed transfer was developed and made followed by trials in trial departments.A questionnaire survey of 214 patients and 27 users was completed and the related situation using separated bed transfer to handle orthopedic patients was surveyed,the results were compared with those of dead lift.Results Compared with traditional dead lift,there was obvious difference in the number of handling participators[≥5 persons:6.07％ (13/214) vs.21.96％(47/214);4 persons:35.51％ (76/214) vs.48.13％(103/214)],patients' comfort during handling [28.97％ (62/214) vs.84.11％(180/214)],x2=43.027,154.381,all P ＜ 0.05.Conclusions It can reduce the number of participators and patients' pain when handling patients using separated bed transfer.It is widely used with lower cost,which is worth being promoted in clinic.

Endourological treatment for benign prostate hyperplasia in elderly high-risk patients / 中华老年医学杂志

Objective To evaluate the safety and effectiveness of endourological techniques in the treatment of benign prostate hyperplasia (BPH) in elderly high-risk patients.Methods A total of 202 BHP patients over 70 years old were treated with endourological techniques and followed up for 3-24 months.Patients were divided into transurethral resection of the prostate(TURP) group (n=90)and transurethral plasmakinetic resection of the prostate(PKRP) group (n =112).Results Compared with pre-treatment,the scores of IPSS and quality of life (QOL),residual urine volume and Qmax were improved in the TURP group after treatment [(6.3±1.2) vs.(27.8±2.5),(1.0±0.4)vs.(5.5±1.1),(18.0±2.8) ml vs.(95.0±18.0) ml,(17.5±1.4) ml/s vs.(5.4±2.0) ml/s,respectively,all P＜0.05].Compared with before treatment,the scores of IPSS and QOL,residual urine volume and Qmax were also improved in the PKRP group after treatment [(8.4 ± 2.5) vs.(27.9±2.3),(1.0±0.4) vs.(1.5±0.5),(25±4) mlvs.(150±26) ml,(19±2.3) ml/svs.(7.0±2.3) ml/s,respectively,all P＜0.05].There were no significant differences in IPSS,QOL,Qmax and RUV between the two groups after treatment (P＞0.05),but the complication incidence was less in PKRP group than in TURP group (6.25％ vs.22.2％,x2 =10.99,P＜0.05).Conclusions PKRP is a safe and effective therapy for elderly high risk patients with BPH.The individual treatment,intensive monitoring and adjustment before operation,and skilled manipulation are the key points to the successful operation.

Clinical significance of CRP、neutrophil granulocyte ratio in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective To study the clinical significance of C-reactive protein(CRP),neutrophil granulocyte ratio(N% ) in acute exacerbations of hospitalized patients with chronic obstructive pulmonary disease ( COPD ). Methods The serum CRP levels,the gross of N% were detected of the same 71 patients with acute exacerbations of COPD before treatment and after getting better. And the correlations among above-mentioned indexes,the days counter before getting better and the days counter during hospitalization were observed. Results (1) The levels of CRP and N% of patients after getting better were significantly lower than those before treatment(P ＜0. 01). (2) There was a significant correlation between N% and the days counter before getting better(r =0.240,P ＜0.05) and also a significant correlation between the days counter before getting better and the days counter during hospitalization (r = 0. 567, P ＜0.01). Conclusion The serum CRP level and N% were objective markers in estimating pulmonary infection in COPD patients with acute exacerbations. And N% was a reliable indicator of judging the days counter before getting better and better than CRP.

The Effects of UTI on Brain Edema and CD11b in Brains of Rats after CPR / 中国现代医生

Objective To observe the effects of UTI on the moisture capacity and CD11b of brains in CPR rats. Methods 30 grown male Sprague Dawley(SD) rats were divided randomly into three groups :control group,resuscitation group and UTI group. Each group had 10 rats. The last two groups were used to make CPR models induced by asphyxia and were observed lasting 2 hours after ROSC. Then all rats were caused dead and brain tissues were took out. Brain tissues were weighed (humid weight),then they were dried in a baker and scaled dry weight. Moisture capacities were calculated by Elliott method. The lever of CD11b in brain tissue was determined by ELISA method. Results ①The brain water content in the resuscitation group was significantly higher than that in the control group[(80.4 ± 2.0)% vs (76.7 ± 1.3)%, P < 0.01];The brain water content in UTI group was decreased significantly than that in the resuscitation group[(77.6 ± 1.5)% vs (80.4 ± 2.0)%, P<0.01]. ②The levels of CD11b of brain tissues in the resuscitation group increased significantly than those in the control group [(620.488 ± 38.723) ng/mg vs (453.189 ± 121.403) ng/mg, P < 0.01]; The levels of CD 11 b of brain tissues in UTI group decreased significantly than those in the resuscitation group[(476.875 ± 114.686)ng/mg vs (620.488 ± 38.723)ng/mg, P < 0.05]. Conclusion Brain edema occurs during the early stage of CPR,and the levers of CD11b in brain tissues increase significantly. The use of UTI may effectively reduce the brain water content,the levels of CD11b in brain tissues.

Advances in radical prostatectomy / 中华男科学杂志

In the western world, adenocarcinoma of the prostate is the most common malignant neoplasm of human males. In recent years, the incidence of the disease has increased dramatically in China. Surgery is an important treatment for prostate cancer. This article reviews the progress in radical retropubic and perineal prostatectomy, standard laparoscopic and robot-assisted laparoscopic radical prostatectomy. It covers the necessity, techniques and experience of surgery, nerve preserving techniques and erectile dysfunction, complications and outcomes, advantages and disadvantages of and comparison between various surgical approaches.

Left renal vein entrapment syndrome (report of 10 cases) / 中华泌尿外科杂志

Objective To evaluate the diagnosis and treatment of left renal vein entrapment syndrome. Methods The clinical data of 10 cases of left renal vein entrapment syndrome were retrospectively analyzed.Their mean age was 24 years (range,14-37 years).Of them 7 cases presented with non-glomerular origin hematuria;2,with orthostatic proteinuria;1 with hematuria accompanied by proteinuria.Color Doppler sonography showed that the dilated segment of the left vein was three-fold than the strictured segment in diameter,and magnetic resonance angiography (MRA) showed that the left renal vein was compressed in 9 cases. Results Stent placement across the left renal vein was performed in 7 cases.Superior mesenteric arteriectomy and replantation were performed in 3 cases.The operations were all successful.Follow-up of 1-5 years showed that the clinical symptoms were improved and urine tests were normal. Conclusions Non-glomerular hematuria or orthostatic proteinuria is frequently found in left renal vein entrapment syndrome.Left renal vein entrapment syndrome can be diagnosed by Doppler sonography,MRA and cystoscopy in the presence of hematuria or proteinuria.Generally,conservative treatment and careful follow-up are conducted in these patients.Surgical and radiologic interventional procedures are effective alternatives for those with glomerular dysfunction and complications.