Objective To explore the related causes and management of the death cases (following) orthotopic heart transplantation (OHT). Methods The data of the death cases (14 cases) were studied retrospectively.Results Fourteen cases died among the total 54 cases of OHT from Aug. 1995 to Dec. 2004 in our hospital. Eight cases died within 1 month and 1 case subject to combined heart-kidney transplantation died on the 38th day, and the other 5 cases died during the period from 17 weeks to 4 years. The death cases died of acute right ventricular failure (4 cases), lung infection (5 cases, including 3 cases associated with fungus infection), acute rejection (4 cases), acute renal failure (4 cases), arrhythmia (4 cases), adult respiratory distress syndrome (2 cases) and diabetes (2 (cases)). The death of 8 cases was related with several causes.Conclusion Various causes should be (responsible) for the results. In order to decrease the mortality rate, the recipients should be selected with low pulmonary vascular resistance and less preoperative complications. It is very important to discover and manage complications in time perioperatively.

Objective To explore the experience of long-term outcomes of orthotopic heart transplantation. Methods From Aug. 1995 to Dec. 2004, 40 patients with end-stage dilatation cardiomyopathy, 36 males and 4 females, aged 13～60 years underwent orthotopic heart transplantation (OHT) , 39 standard styles and 1 total style. Results 40 cases were all successful treated. The survival time is from 8 to 112 months with heart function of 0-I degree. All cases are in good quality of live and enjoy normal entertainments and work. Pulmonary infection and cardiac arrhythmia are the most common complications but they did not degrade the result after proper treatments. Conclusion Heart transplantation is an effective treatment for patients with end-stage heart diseases. Appropriate selections of recipients with low pulmonary vascular resistance, satisfactory myocardial preservation are the key points to success. The precautions and prompt treatments to the postoperative complications are guarantee for the ultimate results of heart transplantations.

[Objective] To observe the effects of Oysters, Abalone shel , Concha arcae, Mother-of-pearl, Concha cypraeae, Clamshel , these six testacean TCM on the goiter rats. [Method] 72 healthy SD rats were randomly divided into nine groups:normal group, model group, positive group and six testacean TCM groups. Rats were given daily propylthiouracil (0.15 g·kg-1), continuous modeling for 10d, weighing thyroid wet weight,assaying T3, T4 and TSH contents in serum by ELISA, observing the morphological changes of thyroid under light microscope. [Result] Rats in the model group compared with normal group in-creased the relative weight of thyroid, reduced the content of T3,T4, and there was a significant difference( P<0.01), thyroid fol icular epithelial cellhyperplasia was obvious;compared with the model group, Oysters and Clamshel group made the content of T3,T4 in rat rebound, and there was a significant difference (P<0.05);Oyster and Clamshel group’s thyroid fol icular cellhyperplasia were not obvious, while the hyperplasia had different levels for the other 4 kinds of testacean TCM. [Conclusion] Oysters and Clamshel were better to improve the thyroid function of the goiter model rats.

Objective To analyze clinical outcomes of the spouse donor kidney transplantation for evaluating the security.Methods Sixty-three cases of living-renal transplantation were divided into two groups, spouse donor group (12 cases) and the other related donor group (53 cases). Twelve cases of spouse-donor(SD)renal transplantation were summarized, that were compared with the nospouse transplantation cases of the other living-related renal transplantation in the same period, which were similar in basic conditions and in immunosuppressant scheme. The observational parameters included average hospitalization time, rate of acute renal necrosis, acute rejection incidence within 1 year, serum creatinine at 7 d, 30 d and 1 year after transplantation.Results The recipient age of the 2 groups was (39±3)years and (37±3)years(P=0.05), dialysis time was (4.7±3.2)months and (4.4±2.9)months(P=0.78), the average hospitalization time was (20.9±8.3)d and (23.0±7.8)d(P=0.41). There was no significant difference between the spouse donor group and the no spouse related donor group. The acute rejection incidence within 1 year was 33.3%(4/12) in spouse group and 3. 9%(2/51) in the other related group, there was significant difference between the 2 groups(P＜0.05). The rate of acute renal necrosis was 16.7%(2/12) in spouse group and 3.9%(2/15)in no spouse related group, there was no significant different between the 2 groups(P＞0.05).SCr was (206.47±47.22)μmol/L and (163. 75±25.91)μmol/L in spouse group at post-operation 7 d and 30 d, and was (142.79±89.42)μmol/L and (119. 99±15.03)μmol/L in no spouse group. There was significant difference between the groups(P=0.02, P=0.00). One year after operation, SCr was (133. 40±6. 11)μmol/L in spouse group and (121. 00±34.12)μmol/L in no spouse group,there was no significant difference between the 2 groups (P=0.25).Conclusions Preoperative comprehensive assessment of the spouse donors and recipients renal transplantation is the guarantee for the success.Short-term outcomes of spouse donor renal transplantation is ideal, but rate of acute rejection within 1 year is higher than that of the other living-relative donor kidney transplantation, which dose not influence the long-time survival of spouse recipients.

Objective To analyze the clinical outcomes and evaluate the safety of living related live donors in kidney transplantation.Methods One hundre and thirty-two cases of living related donors were studied retrospectively for psychological and physiological parameters. The parameters including life quality, urinalysis, serum biochemistry tests, glomerular filtration rate (GFR) and endogenous creatinine clearance rate (CCr) were analyzed.Results There was no significant difference between living related donors and normal people in the aspect of life quality. In living related donors,SCr was (78.33±15.94)μmol/L before operation and was (108.49±19.88)μmol/L at 7 days postoperation, P＜0.05. SCr was (112.47±20. 38)μmol/L at 6 months post-operation. There was no significant difference in SCr levels between 7 days and 6 months post-operation (P=0. 109). CCr was (95.80±20.92)ml/min in pre-operation and was (57.36±14. 92)ml/min at 7 days post-operation,P＜0.05. CCr was (65. 49±8. 25) ml/min at 6 months post-operation. There was no significant difference in CCr between 7 days and 6 months post-operation.The pre-operative total GFR was(74.08±18.51)ml/min. Of which, the right kidney GFR was (38.43±10.33)ml/min. The residual right kidney GFR was (56. 49±13. 01 ) ml/min 6 months after operation, which decreased 17. 59 ml/min (23.8%) compared with pre-operative total GFR (P＜0.05) and increased 18. 06 ml/min (47.0%) compared to the pre-operative right kidney GFR. Surgical complications included 1 case of splenectomy, 1 case of descending colon rupture and 5 cases of wound fat liquefactions.Conclusion Pre-operatively systemic psychological and physiological evaluation on living related donors, detailed consent consultation, standardized operating techniques, careful perioperative management and strict follow-up can improve the safety of living related donors.

Objective To investigate the effect of tMfn2 gene on inhibiting the proliferation of vascular smooth muscle cells (VSMCs) and related mechanism. Method VSMCs were transfected with adenovirus vector encoding tMfn2 or Mfn2 (Adv-tMfn2, Adv-Mfn2). The abundance of tMfn2 protein and Mfn2 protein were deter-mined by Western blot analysis using Mfn2 N-term antibody. The effect of tMfn2 on the proliferation of VSMCs was explored by cell counting and MTT assay. The cell cycle was analyzed using flow cytometry. Western blot were used to detect the expression of p-ERK1/2 and p-Raf-1. Results The results of cell counting and MTT both indi-cated that tMfn2 gene displayed more remarkable effect on inhibiting the proliferation of VSMCs than Mfn2 (P <0.01). Flow cytometry showed that most of the cells infected with Adv-tMfn2 or Adv-Mfn2 were blocked in the stage of G0/G1 and few entered into the S phase. Western blot indicated that overexpression of tMfn2 gene resulted in downregulation of phosphorylated ERK1/2 and Raf-1 protein (P < 0.01). These results demonstrated tMfn2 had stronger effect than Mfn2 (P < 0.01). Conclusions tMfn2 gene is superior to Mfn2 gene in attenuating the proliferation of VSMCs via the Ras-Raf-ERK1/2 signaling pathway.

OBJECTIVETo study the expression of cellular inhibitor of apoptosis protein-2 (C-IAP2) mRNA and protein in hepatocellular carcinoma (HCC) and its relationship with the clinical outcomes.

METHODSQuantitative PCR and immunohistochemical staining were used to detect the expression of C-IAP2 mRNA and protein in the tumor tissues and corresponding adjacent non-cancerous tissues from HCC patients.

RESULTSThe expression of C-IAP2 mRNA in HCC tissues was 2.70 folds higher than that in the non-cancerous tissues (P<0.001). The expression rate of C-IAP2 protein in HCC tissues was 70.8%, significantly higher than that in the non-cancerous tissues (27.8%, P=0.001). The expression of C-IAP2 mRNA and protein was associated with the tumor emboli, lymph node metastasis, AFP level, histological differentiation, TNM stage, postoperative recurrence and metastasis (P<0.05), but not with the patients' gender, age, HbsAg positivity, number of tumors, cirrhosis or the presence of tumor encapsulation (P>0.05).

CONCLUSIONThe expression of C-IAP2 in HCC is associated with tumor recurrence and metastasis, and can be a biological marker for prognostic evaluation of HCC.

Baculoviral IAP Repeat-Containing 3 Protein ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Ubiquitin-Protein Ligases

OBJECTIVETo study the expression of special AT-rich sequence binding protein 1 (SATB1) in hepatocellular carcinoma (HCC) cell lines with different invasive capacities.

METHODSSATB1 expression was detected using real-time fluorescence quantitative PCR, RT-PCR, Western blotting and immunofluorescence in immortalized liver cell line HL-7702, noninvasive HCC cell lines HepG2 and SMMC-7721, MHCC97L cells with low invasiveness, and highly invasive cell lines MHCC97H and HCCLM3.

RESULTSIn comparison with HL-7702 cells, all the 5 HCC cell lines showed overexpression of SATB1 mRNA, which was the highest in the highly invasive HCCLM3 and MHCC97H cells, followed by MHCC97L cell line, and then by SMMC-7721 and HepG2 cell lines (P<0.001). The relative expression quantity of SATB1 protein in HepG2, SMMC-7721, MHCC97L, MHCC97H, and HCCLM3 cell lines was 0.271±0.002, 0.351±0.023, 0.621±0.026, 0.878±0.026, and 1.236±0.006, respectively. SATB1 expression level in HCCLM3 cell line was 4.6-fold higher than that in HepG2 cell line (P<0.001). SATB1 was found to localize in the cytoplasm and cell nuclei of the 5 HCC cell lines, and the highly invasive HCCLM3 and MHCC97H cell lines showed a strong positive staining for SATB1 in immunofluorescence assay.

CONCLUSIONSATB1 expression levels differ distinctly between the HCC cell lines with different invasive capacities and are possibly associated with the metastatic potentials of the cells.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Matrix Attachment Region Binding Proteins ; metabolism ; Neoplasm Invasiveness ; RNA, Messenger ; genetics

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.

OBJECTIVE: To assess the effect of shift work on hypertension in petrochemical production workers. METHODS: Totally 2573 workers were recruited from a petrochemical company by convenience sampling method. We collected the basic information of participants via questionnaire and made occupational physical examination in these subjects to evaluate the relationship shift work with hypertension. RESULTS: The results showed that the prevalence of hypertension in the present study was 15. 1%,and the shift workers were with significant higher prevalence compared with the non-shift workers( 15. 9% vs 10. 7%,P < 0. 05). The systolic blood pressure levels were significant higher in shift work group than that in non-shift work group [( 119. 8 ± 14. 9) vs( 116. 6 ± 13. 7) mmHg,P < 0. 01]. After adjusted for age,gender,education,body mass index,family history of hypertension,and other confounding factors,multiple logistic regression analysis showed that the risk of hypertension in shift work group was 1. 49 times( 95% confidence interval was 1. 05-2. 12)than that of non-shift work group( P < 0. 05). By using stratified analysis by the duration of shift work in the shift workers,the risk of hypertension in the duration of 10-year and 20-year groups were higher than that of the duration less than 10-year group( P < 0. 05). CONCLUSION: Shift work exposure increases the prevalence of hypertension by affecting systolic blood pressure,and this risk can be enhanced with increasing duration of shift work.