Objective To explore the angiogenic function of EPC from peripheral blood in kidney transplanted patient and to reveal its regulative mechanism.Methods 23 chronic renal failure patients without diabetes were recruited in department of Urology Peking University Third Hospital from January 2014 to February 2015.Fasting peripheral blood mixed with heparin (20 U/mL) was collected one day before and 24 hours after kidney transplantation.We set preoperative blood as control and the postoperative blood as the experimental group.EPC from peripheral blood were isolated by density-gradient centrifugation.FACS was used to identify the EPC.The AA metabolites PGE2 in EPC cultured medium was measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Q-PCR and WB were used to detect the expression of endothelial markers in HUVEC cultured under the EPC conditional medium.Tube formation assay was performed to assess the angiogenic ability of HUVEC.Results EPC from kidney transplantation expressed c-kit and CD31 by FACS analysis.Multiple types of AA metabolites was detected in the conditional medium by LC-MS/MS and level of PGE2 increased into two folds after kidney transplantation, compared with that before operation(P ＜ 0.05).HUVEC highly expressed CD31 and VE-cadherin cultured under conditional medium, which were 1.5 folds compared with that before operation (P ＜ 0.01).And those cells formed more tubes than that in control group, which showed better angiogenic capacity.HUVEC, treated by PGE2, had the similar biological characteristics like the conditional culture.Conclusions EPCs in the peripheral blood form kidney transplantation patient secret the PGE2, which can enhance the capacity of angiogenesis in HUVEC.

[Objective To explore the effect of problem-based learning(PBL) in biochemistry teaching in medical college. Methods Totally 128 students(2011 grade) of medical laboratory major were derived into experiment group(n=64)and control group(n=64). Lecture-based learning(LBL) was used in control group and PBL was used in experiment group.In control group,teachers did teaching design according to the needs of curriculum standards,employed multimedia courseware,explained the basic content of each chapter,class exercises and homework after class. In experimental group,PBL was conducted through establishing biochemistry teaching website based on school's teaching platform. Teach-ing process in experiment group included:grouping-selecting appropriate cases-consulting data-group discussing-summarizing by teachers. Theory test was carried out after the course and questionnaire was conducted for students in experiment group . Data were analyzed using the independent sample t test . Results Average test scores were higher in PBL group than in traditional group,with statistically signif-icant differences[(83.15±11.87)vs. (76.15±12.48)]. Questionnaire survey showed that more than 90.0%students in experiment group were interested in the PBL teaching method and thought that the PBL teach-ing method can enhance the enthu-siasm of learning, independent learning ability and comprehensive analysis ability. Conclusions PBL teaching method can improve the quality and the effect of biochemi-stry teaching and culture students' comprehensive ability. It is worthy of further study and popularization.

Objective To investigate the relationship of sperm morphology with seminal plasma zinc and sperm acrosin activity in male infertile patients.Methods 455 patients with male infertility were divided into 5 groups and 8 groups according to age and sperm morphology respectively.The sperm morphology,seminal plasma zinc and sperm acrosin activity were detected by the Diff-Quik stain,modified 5-Br-PAPS and modified Kennedy methods respectively.Results The percentages of morphologically normal sperm and seminal plasma zinc concentration in the infertile men groups were not different in various age groups(P >0.05 ).The sperm acrosin activity in the age group of 36-50 years was remarkably decreased (P <0.05),while which in other age groups had no statistical difference(P >0.05).Seminal plasma zinc concentration in the infertile men groups were not different in the 8 groups (P >0.05 ).Sperm acrosin activity was decreased with the percentage decrease of morphologically normal sperm (r =0.93,P <0.01).Conclusion The percentage of morphologically normal sperm is not affectd by the age and the seminal plasma zinc,which is positively correlated with the sperm acrosin activity.

OBJECTIVE:To compare the anti-inflammation,analgesia effects of decoctions extracted from Aconiti lateralis with different leaf shapes(dahua leaf,xiaohua leaf)from different producing areas(Jiangyou,Butuo). METHODS:Animals were randomly divided into blank group(distilled water),positive group,groups of Aconiti lateralis with dahua,xiaohua leaf from Ji-angyou,groups of Aconiti lateralis with dahua,xiaohua leaf from Butuo(with dose of 5 g/kg,calculated by crude drug). The an-ti-inflammation effect of decoctions extracted from Aconiti lateralis with different variety sources and leaf shapes was investigated by xylene-induced ear swelling test (n=12) in mice and egg white-induced toe swelling test (n=10) in rats (positive drug was Dexamethasone acetate tablet,0.005 g/kg). And its analgesic effect was investigated by acetic acid-induced writhing body reaction test(n=12)and hot-plate-induced pain test(n=12)in mice(positive drug was Morphine hydrochloride tablet,0.0025 g/kg). RE-SULTS:The decoctions extracted from Aconiti lateralis with dahua,xiaohua leaf from Butuo and xiaohua leaf from Jiangyou can significantly reduce the ear swelling degree(P<0.01). The decoctions extracted from Aconiti lateralis with dahua leaf from Jiangy-ou and Butuo can significantly decrease the toe swelling degree after 6 h of medication(P<0.05). And decoctions extracted from Aconiti lateralis with xiaohua leaf from Butuo can significantly reduce the number of writhing body in mice with acetic acid-in-duced pain and prolong the pain threshold of mice with hot-plate-induced pain (P<0.05 or P<0.01). CONCLUSIONS:Aconiti lateralis with dahua and xiaohua leaf from Butuo and with xiaohua leaf from Jiangyou show better anti-inflammation effect,and Aconiti lateralis with xiaohua leaf from Butuo shows better analgesic effect.

Objective:To investigate the effect and mechanisms of Phloroglucinol ( PG) on renal ische-mia and reperfusion injury (IRI).Methods:Forty-eight male Wistar rats were divided into 3 groups (16 rats per group):sham operated, saline-treated I/R (I/R), and PG-treated I/R (PG).I/R model:Af-ter removing the right kidney , renal I/R injury was induced by clamping the left renal artery for 45 min followed by reperfusion.The rats were administered with PG (30 mg/kg, intraperitoneally) or saline 15 min before renal ischemia .The blood and kidneys were harvested 6 and 24 h after reperfusion .Renal function and histologic changes of serum creatinine (SCr) and blood urea nitrogen(BUN)were assessed. Malondialdehyde (MDA),catalase (CAT),superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were measured.Nuclear factor-kapa B ( NF-κB) and caspase-3 in the kidneys were also measured.Results:SCr and BUN were (103.9 ±10.4) μmol/L and (15.2 ±1.0) mmol/L in I/R group, and (81.8 ±13.4) μmol/L and (11.5 ±1.2) mmol/L in PG group 6 h after reperfusion .SCr and BUN were (154.9 ±12.1) μmol/L and (28.1 ±1.4) mmol/L in I/R group, and (103.8 ±5.9)μmol/L和(16.0 ±1.0) mmol/L in PG group 24 h after reperfusion.PG treatment significantly attenua-ted renal dysfunction and histologic damage caused by I /R injury(P<0.05).The I/R-induced elevation in kidney MDA level decreased , where as reduced kidney SOD ,CAT and GSH-Px were increased .What is more , the apoptotic tubular cells , the levels of active caspase-3 ,and active nuclear factor kappa B dra-matically decreased after PG treatment .Conclusion:PG protects murine kidney I/R injury by suppres-sing oxidative stress , inflammation , and cell apoptosis .

Objective To diagnose a rare variant Hb Shaare Zedek in a Chinese family,and describe its clinical feature.Methods Blood samples of seven members of three generation were collected.Standard blood routine analysis,hemoglobin electrophoresis and blood gas analysis were used for phenotype analysis.Gap-PCR and reverse dot blot analysis were used to detect common thalassemia mutations.DNA sequence analysis of the human α and β globin genes were used to identify the mutation site of these samples.Results The result of blood routine analysis was normal in the proband,but a abnormal hemoglobin band (22.4％,capillary assay) was found by hemoglobin electrophoresis.In the blood gas analysis,the partial pressure of oxygen and blood oxygen saturation were 72.0 mm Hg ( 1 mm Hg =0.133 kPa) and 93.0％ in the proband.The heterozygous mutations in αl globin gene at codon 56 ( AAG ＞ GAG)which leaded Glu substitution to Lys were identified in the proband.Other family members who carried the same mutation showed similar phenotype,with abnormal hemoglobin band ( 22.4％ - 23.9％,capillary assay),low partial pressure of oxygen (59.0 - 72.0 mm Hg) and blood oxygen saturation (91.0％ -93.0％).Conclusions The heterozygote of Hb Shaare Zedek leads to slight symptoms with abnormal hemoglobin band,decreased partial pressure of oxygen and blood oxygen saturation.Discovery of this mutation enriches the abnormal hemoglobin spetrum of Chinese people,and it is useful for the clinical diagnosis and genetic counseling of hemoglobinopathies.

Zoster sine herpete (ZSH) is one of the atypical clinical manifestations of herpes zoster (HZ), which stems from infection and reactivation of the varicella-zoster virus (VZV) in the cranial nerve, spinal nerve, viscera, or autonomic nerve. Patients with ZSH display variable symptoms, such as neuralgia, however, different from HZ, ZSH show no zoster, which makes clinical diagnosis difficult. ZSH not only causes initial symptoms, such as neuropathic pain in the affected nerve, Bell palsy, and Ramsay Hunt syndrome, but also postherpetic neuralgia and fatal complications such as VZV encephalitis and stroke. The misdiagnosis of ZSH and tardy antiviral treatment may lead to severe ZSH sequelae. We review the publications related to ZSH, especially its diagnosis with VZV DNA and/or anti-VZV immunoglobulin (IgG and IgM). More work about ZSH, especially ZSH epidemiological survey and guidelines for its diagnosis and treatment, are needed because most of the present studies are case reports.

OBJECTIVETo investigate the diagnosis, treatment and surgical outcomes of ureteropelvic junction obstruction (UPJO) caused by renal crossing vessels.

METHODSThe case records of 24 patients discharged from Peking University Third Hospital between June 2001 and September 2011 with the diagnosis of UPJO caused by renal crossing vessels were reviewed .Of the 24 patients, 17 were male and 7 were female patients. The mean age was 28 years (range, 2-63 years). The mean disease duration was 22.3 months (range, 7 days to 180 months). Of which, 4 patients underwent open surgery, and the other 20 patients were treated with laparoscopic surgery. Surgical approach was decided by operative conditions: adhesion release technique, dismembered pyeloplasty or Y-V anastomosisor, with or without cut off the crossing vessels. The kind of crossing vessels was recorded, and the effect of surgery was evaluated by follow-up.

RESULTSFifteen cases were caused by oppressed renal crossing artery, 8 cases by renal crossing vein, and 1 case by 2 renal crossing arteries and 1 renal crossing vein. Among them, 11 cases were followed up successfully. Average follow-up time was 48.2 months (range, 13-120 months). Eight cases (8/11) were relieved, and 1 case (1/11) had no obvious improvement, another 2 cases (2/11) were aggravating. Among those 6 cases underwent adhesion release technique, 3 cases were relieved, 1 case had no obvious improvement, and 2 cases were aggravating. Five cases who underwent dismembered pyeloplasty was relieved significantly.

CONCLUSIONSRenal crossing artery is one of the main causes of UPJO, the crossing artery should be retained as far as possible. Crossing vessel oppression is not the only pathological cause of UPJO, so the treatment of UPJ constriction is also very important. Dismembered pyeloplasty seems to be the most efficacies treatment procedure for UPJO caused by repressed vessels, and the remission rate of adhesion release technique seems limited.

Adolescent ; Adult ; Arteries ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Hydronephrosis ; congenital ; etiology ; surgery ; Kidney ; blood supply ; Kidney Pelvis ; blood supply ; Laparoscopy ; methods ; Male ; Middle Aged ; Multicystic Dysplastic Kidney ; etiology ; surgery ; Renal Artery ; abnormalities ; Treatment Outcome ; Ureteral Obstruction ; etiology ; surgery ; Young Adult

ObjectiveTo evaluate the efficacy and safety of HC-A Ⅱsolution in kidney preservation.Methods A multicenter,randomized,double-blind and controlled clinical trial was conducted.Between Jan.2008 and Dec.2010,kidney recipients from 9 transplant centers were randomly divided into two groups.Grafts in each group were perfused and stored in HC-A Ⅱ or HTK solutions respectively.Results277 patients were included in the Full Analysis Set (FAS),137 of whom were inHC-A Ⅱgroup and 140inHTK group. Demographic andbaseline medical characteristics were similar between the two groups.262 patients were included in the Per Protocol Set (PPS),133 of whom were in HC-A Ⅱ group and129 in HTK group.The percentages of patients with a serum creatinine level that returned to normal within 28 days postoperation were 86.9％ in HC-A Ⅱ group and 85.0％ in HTK group respectively (P＞0.05 ).The results from PPS analysis were consistent with those from FAS analysis The incidence of test-related adverse events was 2.9％ in HC-AⅡ group and 0.7％ in HTK group respectively (P＞0.05).No test-related serious adverse events occurred throughout the study.ConclusionHC-A Ⅱ solution,the same as HTK solution,is safe and effective in kidney preservation.

Objective:To disiuss the application of liver free technique in renal cell carcinoma patients with Mayo Ⅱ-Ⅳ tumor thrombus.Methods:The clinical data of renal cell carcinoma patients with MayoⅡ-Ⅳ IVC tumor thrombus in our hospital from January 2014 to December 2019 were retrospectively analyzed. 25 patients underwent right part of liver or hepatic portal part dissection via open abdominal approach. There were 20 males and 5 females, aged 45-74 years (mean 61±6 years). All patients underwent urinary tract CTU or MRU examination, vena cava enhanced magnetic resonance angiography.There were left 8 cases, right 17 cases; the median length of tumor was 7 cm (3.6-12.1 cm). There were 1 case of Mayo grade Ⅱ tumor thrombus, 7 cases of Mayo grade Ⅲ tumor thrombus, and 17 cases of Mayo grade Ⅳ tumor thrombus. There were 7 cases of distant metastasis, including 6 cases of lung metastasis and 1 case of bone metastasis. After multi-disciplinary consultation (MDT), 19 patients underwent radical nephrectomy and 6 patients underwent tumor reducing nephrectomy. During the operation, the ligaments around the liver were completely dissociated and the space between the liver and kidney was opened. The bare area of the liver was fully dissociated, to expose the inferior vena cava. For Mayo grade Ⅳ tumor thrombus, 11 cases were treated with free diaphragmatic thrombus removal without thoracotomy, and 6 cases were treated with open chest cardiopulmonary bypass.Results:The median operation time was 444(258-694)min, the median intraoperative blood loss was 2 000(250-10 000)ml, and the median value of suspended red blood cell transfusion was 1 300(400-10 400)ml. The median postoperative hospital stay was 10(4-25)days.15 patients (60%) had postoperative complications, including 8 cases of liver injury, 5 cases of respiratory complications, 4 cases of kidney injury, 3 cases of anemia, 3 cases of infection and 1 case of thrombosis. Three patients died during perioperative period.Conclusions:The application of total liver free technique might obtain good exposure of surgical field, effectively control the hemorrhage of inferior vena cava, which is helpful for safe resection of tumor.