1.The effect on liver function after kidney transplantation of HBV carriers: comparison between tacrolimus and cyclosporin A
Guodong CHEN ; Lizhong CHEN ; Changxi WANG
Chinese Journal of Organ Transplantation 2005;0(09):-
Objective To observe the effect of tacrolimus vs cyclosporin A on liver function after kidney transplantation. Methods Seventy-three cases of HBV carriers received kidney transplantation. Their liver functions before operation were normal and HBV DNA was negative. After operation they were divided into two groups: FK506 group (n=40) taking FK506, mycofenolate mofetil (MMF) and prednisone to prevent rejection. CsA group (n=33) taking CsA, MMF and prednisone to prevent rejection. The cases were followed for 1 to 6 years. The incidence of liver function admage and HBV DNA positive rate were observed in two groups. When damage to liver function appeared, the doses of immunosuppresive drugs were regulated, and the drugs protecting liver function were given. Results Four cases ( 10.0 % ) in FK506 group and 16 cases ( 48.5 %) in CsA group suffered the damage to liver function. In 2 cases ( 5.0 %) of FK506 group and 9 cases ( 27.3 %) of CsA group, HBV-DNA transferred to positive (P
2.Corrective therapy for different kinds of open bite malformations
Changxi SHI ; Jihua CHEN ; Hui WANG
Chinese Journal of Medical Aesthetics and Cosmetology 2002;0(01):-
Objective To investigate the effects of a corrective tr ea tment on open bite malformations, such as gnash their teeth, nail-biting, tongu e thrusting, impacted tooth, cross bite with improper correction, open bite defo rmity resulted from premature shedding of deciduous tooth and molar cysts. Methods We used dental resin technology: acid etching the teeth, adh ering metal clasps to the teeth by means of composite resin, and applying elasti c bands for intermaxillary traction to correct the cross bite. Results We had treated 22 patients, age ranged from 7-30, with the malformatio ns resulted from different kinds of reasons, and obtained significant results. Conclusion With cooperation of the patients, simple corrections for open bite with sticky clasp and occlusion with elastic band are easy to car ry on, with short period of treatment time, and every patient gets prominent out come. It is effective, prior to commonly-used corrective therapy and deserves t o be widely used.
3.Therapeutic effect of rapamycin in the treatment of malignancies in recipients after kidney transplantation
Changxi WANG ; Longshan LIU ; Lizhong CHEN
Chinese Journal of Organ Transplantation 2003;0(05):-
Objective To investigate the therapeutic effect of rapamycin in the treatment of malignancies after kidney transplantation (KT).Methods Of the 23 inoperable patients with malignancies after KT, 8 (RPM group) received Rapamycin as treatment as well as there immunosuppressive regimens were modulated, and the remaining 15 (non-RPM group) were treated only by immunosuppressive regimen modulation, some of whom also received chemotherapy. The survival of the patients in the two groups was compared.Results In RPM group, the median survival time was (14.5) months and no acute rejection (AR) occurred during whole follow-up period. There are still 7 patients alive at the end of this study. One recipient with Kaposi’s sarcoma developed AR because of RPM dose reduction, and finally died of transplanted kidney failure and pulmonary infection. In non-RPM group, the median survival time was (3.0) months, and all of them died during the follow-up period. The 12- and 20-month survival rates were respectively (75.0) % and (37.5) % in RPM group, while (7.1) % and 0 in non-RPM group with the difference being statistically significant (P
4.Therapeutic role of glucocorticoid in treating CMV severe pneumonia after kidney transplantation
Jiguang FEI ; Lizhong CHEN ; Changxi WANG
Chinese Journal of Organ Transplantation 2005;0(12):-
Objective To investigate the therapeutic role of glucocorticoid in treating cytomegalovirus (CMV) severe pneumonia after kidney transplantation. Methods Two groups of patients with CMV severe pneumonia after kidney transplantation were analyzed. The therapeutics for 12 patients of group A included the elimination of immunosuppressive agents such as cyclosporine (or tacrolimus) and cellcept, the use of antiviral drug such as gancyclovir, measures to prevent and cure other bacterial and fungal infections, supportive therapies and suck of oxygen or mechanical ventilation by respirators. Except for the above therapies, methylprednisolone was routinely injected to those 14 patients of group B. At the beginning, the dose of methylprednisolone was 120 mg/day to 150 mg/day. Three to five days later, the dose was decreased to 80 mg/day. The dose was further decreased to 40 mg/day when patients’ signs were improved. After patients’ signs were excluded, prednisone was taken orally in place of methylprednisolone. In our patients, methylprednisolone was used for average 12 days, ranging from 8 to 21 days. Results Among the patients of group A, 9 (75 %) were treated with mechanical ventilation by respirators, 7 ( 58.33 %) died and 2 ( 16.67 %) received dialysis due to dysfunction of the transplanted kidneys. Among the patients of group B, 4 ( 28.57 %) were treated with mechanical ventilation by respirators, 2 ( 14.29 %) died and no case with the transplanted kidney loss was found. There were significant differences between the two groups on the probability of using mechanical ventilation by respirators and the mortality (P= 0.047 and P= 0.038 respectively). In the patients of group B, no severe side effects caused by methylprednisolone were found. Conclusion The treatment with proper dose of methylprednisolone may extenuate effectively the inflammatory reaction from the CMV severe pneumonia after kidney transplantation while reduce the rejection related to the absence of other immunosuppressants and decrease the mortality and the rate of transplanted kidney loss.
5.Diagnosis and treatment of vascular complication after renal allograft transplantation
Changxi WANG ; Longshan LIU ; Lizhong CHEN
Chinese Journal of Organ Transplantation 2005;0(07):-
Objective To investigate the diagnosis and treatment of vascular complications after allograft kidney transplantation.Methods The clinical data of 34 patients with vascular complications after renal allograft transplantation were retrospectively studied,and the characteristics,diagnosis and therapeutics were analyzed.Results Among the 34 patients,there were 13 cases of allograft renal(artery) obstruction,8 cases of allograft renal artery hemorrhage,7 cases of arterial anastomosis(rupture),4 cases of allograft renal vein obstruction,1 case of external iliac artery aneurysm and 1 case of external iliac vein thrombosis.Diagnosis was made in 21 patients by color Doppler flow imaging(CDFI),among whom 10 received further examination of magnetic resonance angiography(MRA).In the 5 cases of allograft renal artery stenosis(TRAS),3 came out with well renal function after the placement of endovascular stents.During the follow-up duration of 8,10 and 14 months,their serum creatinine(Scr) maintained between 115 and 135 ?mol/L.TRAS patient's allograft renal artery which had been anastomosed end-to-end with internal iliac artery was shifted to end-to-side style with(external) iliac artery at the second time,and came out with normal Scr one month postoperation.One TRAS patient received conservative treatment because MRA examination indicated only mild stenosis,and his Scr has been decreasing for 21 days till now.Three patients with allograft renal vein(obstruction) was treated with surgery,in whom one died of heart failure,and the other 2 patients'(renal) function recovered well during the follow-up of respectively 13 and 36 months.One patient with external iliac vein thrombus died of allograft rupture.All the other patients underwent allograft(resection).Conclusion Vascular complications after renal transplantation progresses fast once(developed) with a poor prognosis,so early diagnosis is essential for graft as well as survival and(effective) management should be administrated accordingly.CDFI could be the first choose for screening.
6.Mechanical properties of dental base resins prepared with the fast automatic dental base resin hydraulic pressure cooker
Tangmin ZHAO ; Changxi SHI ; Jihua CHEN
Journal of Practical Stomatology 2001;0(01):-
0.05), the FADRHPC could save a great amount of time and worked automatically. Conclusion: The FADRHPC can simplify manipulation processes and make satisfied dentures.
7.The effect of thickness on the fracture resistance of hot pressable ceramic crowns
Hui WANG ; Jihua CHEN ; Changxi SHI
Journal of Practical Stomatology 2001;0(03):-
0.05) than those with that of 1.0 mm (P
8.The surgical strategy of horseshoe kidney transplantation:a report of two cases and literature review
Changxi WANG ; Liang ZHAO ; Lizhong CHEN
Chinese Journal of Organ Transplantation 1996;0(04):-
Objective To study the feasibility and safety of horseshoe kidney transplantation and avoid the waste of the donor kidney. Methods The horseshoe kidney was identified and confirmed during the organ procurement process. It was perfused in situ and procured en bloc. With an appropriate dissection and reconstruction on the beach table, the horseshoe kidney was carefully divided at the isthmus and transplanted into two separate recipients. The surgical strategies and postoperative outcomes of transplanting the cadaveric horseshoe kidneys were evaluated. Results Two recipients had a immediate return of renal function after the blood vessels were opened. One recipient had a normal renal function presented as lower post-transplant serum creatinine values with a follow-up of 12 months. There was no complications related to the horseshoe kidney. Another case died of infection 1.5 month later after the transplantation. Conclusions Cadaveric horseshoe kidney may be transplanted successfully using various individual technical strategies based on the specific renal anatomy. Considering the lack of donor horseshoe kidney transplantation is feasible and safe.
9.A comparison of long-term effect and safety between tacrolimus and cyclosporine in cadaveric renal transplantation
Lizhong CHEN ; Changxi WANG ; Jiguang FEI
Chinese Journal of Organ Transplantation 2003;0(05):-
Objective To compare the long-term effect and safety between tacrolimus (FK506) and cyclosporine (CsA) in patients receiving cadaveric renal transplantation. Method A total of 210 patients were randomized to FK506 and CsA after cadaveric renal transplantation, and were followed up for 12-32 months for the variation of trough concentration in whole blood, the incidence of acute rejection and chronic rejection, one-year survival rate of patient/graft, variation of creatinine level, impairment of liver function and glucose metabolism and lipid metabolism, incidence of infection, and side effects. Results The variation of trough concentration of FK506 was similar to CsA. The incidence of acute rejection was significantly lower in FK506 group than in CsA group ( 16.3 % vs 33.0 % , P 0.05 ). The incidence of impaired liver function and impaired lipid metabolism and gingivitis and creatinine level three months after transplantation were significantly lower in FK506 group than in CsA group ( P
10.Different types of Budd Chiari syndrome showed different circulation directions
Bochang CHEN ; Changxi LIN ; Zhengping GU
Journal of Interventional Radiology 1994;0(04):-
Objective To improve the knowledge for flow direction of renal spleen circulation in Budd Chiari syndrome and effects in treatment. Methods Two Budd Chiari syndrome patients with reno splenic venous shunt were treated by PTA, and the circulation directions were investigated. Results One case with hepatic vein occlusion showed the circulation from left renal spleen vein to IVC; another case with IVC stenosis proximal to heart showed the flow direction from spleen left renal vein to varices and finally to SVC. The circulation disappeared after treatment with PTA.Conclusions The direction of circulation in different types of Budd Chiari with portal hypertension may be different and should be identified clearly for a suitable management.