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BACKGROUND:Increasing attention has been paid on the role of advanced glycation end products in bone tissue. Glucose metabolic disorder is one of the main reasons for the increase of advanced glycation end products. OBJECTIVE:To observe the change of advanced glycation end products expressed in type 2 diabetes rats, and to investigate the relationship between impaired fracture healing and change of advanced glycation end products expression in vivo. METHODS:Thirty Sprague-Dawley rats were randomly and equal y divided into two groups:control group (normal feeding) and experimental group (high fat and sucrosum diet feeding to establish type 2 diabetes model). After diabetes models were established, the model of distraction osteogenesis in the left tibiae of al the rats was produced. Distraction was given 0.3 mm per day and continued for 14 days. RESULTS AND CONCLUSION:After the traction was complete, cal us formation in distraction gap was obviously reduced in experimental group compared with control group by X-ray examination. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis by histology examination. The enzyme-linked immunosorbent assay results showed that, the level of advanced glycation end products was obviously elevated (P<0.01) while osteocalcin was obviously reduced (P<0.01) in experimental group in comparison with control group. The formation of distraction cal us was impaired in the process of fracture healing and blood of type 2 diabetes rats. The increase of advanced glycation end products may be one of the reasons that cause impaired fracture healing in diabetic rats.
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Objective To investigate the effect of salvia Miltiorrhiza on the patients with chronic allograft nephropathy.Method 20 cases were treated by the combination of salvia miltiorrhiza and routine anti-rejection therapy.Results The effect of the combination in salvia group was better than that in the control group .The significant difference was found between the two groups of the patients (P
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Objective To investigate the alteration of lymphocyte P-gp expression level and function in liver transplant recipient and its effect on immunosuppressive therapy.Methods Using flow cytometry,the level of lymphocyte P-gp and analyzed the P-gp function in 53 cases of liver transplant recipieints was observed.Results Among 53 cases,the preoperative mean level of lymphocyte P-gp was(10.34?4.0)%,P-gp level began to increase in the 1st month postoperatively(17.8?8.0)%,peaked in the 3rd month(27.5?13.3)%,and then was stable at this level thereafter.There were no significantly difference between different sex of age group.But the P-gp level in CD+4T cells was significantly higher than that in CD+8T cells and B cells,RH123test showed that high P-gp expression of lymphocyte enhanced its transport activity of medical agents,and decreased the intracellular accumulation of drug more significantly than that of low P-gp expression(P
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0.05). PBF was still increased more then normal values 1 years after OLT(P
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Objective To explore the features, diagnosis and treatment of pulmonary infection after kidney transplantation. Methods The clinical data of 31 pulmonary infection cases among 150 patients underwent kidney transplantation were analyzed retrospectively. Results The 31 patients with pulmonary infection after kidney transplantation included 9 cases of simple bacterial infection, 3 cases of fungus infection, 5 cases of CMV infection, 1 case of TB, 10 cases of mixed infection, and 3 cases of infection with unclear pathogen. 27 cases of the patients(27/31,87.1%) were cured, while 4 cases died of pulmonary infection. Conclusion Pulmonary infection is a common and severe complication after kidney transplantation. Early etiological diagnosis, the prompt treatment of antibacterium,antivirus and antifungus, adjustment of immunosuppression regime, and strengthening the support therapy would improve the curative rate.
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Objective To investigate the morbidity of cholecystic disease in renal transplant candidates and study the indications of prophylactic laparoscopic cholecystectomy(LC) for renal transplant candidates with cholecystic disease. Methods The incidence of cholecystic disease in 286 renal transplant candidates in our institution in recent four years was retrospectively reviewed.All the candidates had received one or more ultrasonographic examinations. Results Cholecystic disease was found in 32 of 286 candidates ((11.1)%), including cholelithiasis in twenty(62.4%, 20/32), sludge in six(18.8%, 6/32)and polypoid lesion in six(18.8%, 6/32). Cholecystectomy had been performed in twenty candidates with symptomatic chronic cholecystitis before transplantation, including LC in fourteen and open cholecystectomy with small incision in six .Five of twelve candidates without symptoms received prophylactic LC electively .In three of the other 7 candidates acute cholecystitis occured within six month after transplantation.There was no death of the (candidates) and no grafts function loss occurred in this series. Conclusions Cholelithiasis is the major cause of cholecystic disease in renal transplant candidates. Electively prophylactic LC is recommended for the (candidates) with or without symptomatic cholecystitis before transplantation or before acute cholecystitis has (occured).
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Objective To summarize the clinical experience of standard piggyback liver transplantation(SPBLT) and modified piggy-back liver transplantation(MPBLT) in the treatment of Wilson′s disease(WD).Methods The clinical records of 29 cases of WD who underwent piggyback liver transplantation over the recent 12 years were analyzed retrospestively.Among them,there were 22 male and 7 female patients,with 6cases aged 8-14y and 23 cases aged 24-37y,who underwent liver transplantation because of chronic advanced liver disease(18cases),fulminant hepatic failure(2 cases),or with normal liver function(9 case),and among them,24 cases showed neurological dysfunction.The modes of operation included SPBLT(13 cases) and MPBLT(16 cases).Results The patients were followed up for 1 month-12 years with the median follow-up time of 47 months.Four patients died in the perioperative period,of which 2 died of hepatic failure due to obstruction of hepatic venous return after SPBLT,and 2 died of hepatic artery thrombosis and bile leakage combined with severe infection.The recipient survival rate at 1 year and 3 years was 86% and 79% respectively.One patient has survived for 12 years.All the levels of serum copper and copper-protein recovered to normal in four weeks post-operatively.Neurological symptoms improved in varying degrees after operation.Conclusions WD patients who undergo PBLT can expect a satisfactory clinical outcome and a good quality of life,and MPBLT can effectively reduce the complications of operation and improve the operation survival rate.
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Objective To investigate the renal hemodynamic changes after orthotopic liver transplantation(OLT)and the correlative parameters. Methods In 20 patients undergoing OLT for cirrhosis,the following renal arterial resistance index(RI) was measured before surgery and 7days,30days, 6 months and 1 year after operation by using color Doppler flow imaging(CDFI) and serum creatinine detection.Meanwhile the same parameters were measured in 10 healthy as controls. Results Both RI and serum Cr rised after OLT ( P 0.05). Conclusions Most alteration of renal hemodynamic parameters in cirrhosis are restored to normal after OLT in 1 year. Preoperative renal abnormalities and intraopterative alteration of hemodynamic may contribute to postoperative renal dysfunction. Cyclosporine (CsA) is the most likely etiologic agent of postoperative renal dysfunction.
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Objective To study the diagnosis and prophylaxis of postoperative infections within 1 month after orthotopic liver transplantation(OLT). Methods Clinical date of 38 consecutive patients who underwent OLT at our institution from 2001 to 2003 were retrospectively reviewed. Result Eighteen patients( 47.4% ) developed twenty-nine times infection after operation .Respiratory tract and peritoneum were the common infectious sites(37.9% and 24.1%). Enterobacter cloacae(8 of 29, 27.6%) , Escherichia coli(7 of 29, 24.1%),staphylococcus aureus(6 of 29, 20.7%) were the commonest bacterial.The mortality of infection was 38.9%(7/18). Identified risk factors for infection including: previous transplantation ; duration of operation; transfusion requirements during surgery; type of biliary anastomosis; delayed restoration of gastrointestinal function and persistent postoperative hyperglucocemia . Perioperative decontamination of the digestive tract had a protective effect. Conclusions Infections are a major cause of death among liver transplant recipients. Reducing risk factors of infection and perioperative decontamination of the digestive tract may decrease the occurrence of postoperative infection.
