Simultaneous pancreas and kidney transplantation for 5 patients with diabetesplus end-stage renal disease / 中华器官移植杂志

Objective To reduce the perioperative complications of simultaneous pancreas and kidney transplantation (SPK ) and boost the clinical efficacy by exploring its perioperative management in diabetics with end-stage renal disease .Methods Retrospective analysis was performed for the clinical data of 5 diabetics with end-stage renal disease undergoing SPK since 2017 .Results The cold ischemic time of all allografts was under 8 hours .No surgical complications occurred in recipients post-transplantation .Two patients were complicated with hyperkalemia and their serum potassium levels normalized after treatment .One case of bleeding in abdominal cavity was cured conservatively . Renal functions of two patients with delayed renal function post-transplantation gradually recovered after hematodialysis . One case of peritransplant fluid collection recovered after debridement and drainage .Another case of acute left heart failure and cardiac arrest at 45 days post-transplantation resumed normal heart rhythm after rescue .However ,his consciousness could not be restored and his families gave up subsequent treatments . Transplanted kidneys and pancreases of these 4 patients normalized .Follow-up was conducted until March 20 , 2019 . They became insulin and dialysis independent and serum creatinine and blood glucose normalized .Diabetic complications were relieved and their quality-of-life also improved significantly .Conclusions SPK is an effective treatment for diabetics with end-stage renal disease .While maintaining normal serum creatinine and blood glucose , it may liberate patients from insulin dosing and dialytic maintenance ,lower diabetic complications and improve quality-of-life .

Novel Prognostic Nomograms for Hepatocellular Carcinoma Patients with Microvascular Invasion: Experience from a Single Center

BACKGROUND/AIMS: Microvascular invasion (MVI) is an established risk factor for hepatocellular carcinoma (HCC). However, prediction models that specifically focus on the individual prognoses of HCC patients with MVI is lacking. METHODS: A total of 385 HCC patients with MVI were randomly assigned to training and validation cohorts in a 2:1 ratio. The outcomes were disease-free survival (DFS) and overall survival (OS). Prognostic nomograms were established based on the results of multivariate analyses. The concordance index (C-index), calibration plots and Kaplan-Meier curves were employed to evaluate the accuracy, calibration and discriminatory ability of the models. RESULTS: The independent risk factors for both DFS and OS included age, tumor size, tumor number, the presence of gross vascular invasion, and the presence of Glisson's capsule invasion. The platelet-to-lymphocyte ratio was another risk factor for OS. On the basis of these predictors, two nomograms for DFS and OS were constructed. The C-index values of the nomograms for DFS and OS were 0.712 (95% confidence interval [CI], 0.679 to 0.745; p<0.001) and 0.698 (95% CI, 0.657 to 0.739; p<0.001), respectively, in the training cohort and 0.704 (95% CI, 0.650 to 0.708; p<0.001) and 0.673 (95% CI, 0.607 to 0.739; p<0.001), respectively, in the validation cohort. The calibration curves showed optimal agreement between the predicted and observed survival rates. The Kaplan-Meier curves suggested that these two nomograms had satisfactory discriminatory abilities. CONCLUSIONS: These novel predictive models have satisfactory accuracy and discriminatory abilities in predicting the prognosis of HCC patients with MVI after hepatectomy.

A primary study of endoscopic closure of acute gastric perforation using twin grasper combined with endoloops in a porcine survival model / 中华消化内镜杂志

Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

Study of Dominant-positive Heat Shock Factor 1 on 6-OHDA-induced Cell Death / 中国生物工程杂志

In eukaryotic cells,heat shock factor 1 is the main specific transcription factor mediating the enhanced expression of heat shock proteins when cells experience stresses.It is kept in a latent state by inhibitory complexes under unstressed conditions.It is only transiently activated in response to diverse forms stresses.Dominant-positive heat shock factor 1 has been developed through deletion-mutation.It can activate the expression of endogenous heat shock proteins in the absence of stresses.Environmental neurotoxins play an important role in the pathogenesis of Parkinson's disease.The neurotoxins induce cell death of dopamine neurons through oxidative damage.The results of Western blot and dual-luciferase analysis indicate that the expression of HSP70 was greatly up-regulated in dopaminergic SH-SY5Y cells transfected with dominant-positive heat shock factor 1.To investigate the effect of dominant-positive heat shock factor 1 on 6-OHDA-induced apoptosis in dopaminergic SH-SY5Y cells,the release of lactate dehydrogenase was detected.The result argues that dominant-positive heat shock factor 1 significantly inhibits neurotoxin 6-OHDA-induced cell death in SH-SY5Y cells.The cyto-protective role may be attributed to HSP70 activated by dominant-positive heat shock factor 1.Taken together,it is possible that dominant-positive heat shock factor 1 can be used to prevent or cure Parkinson's disease.