Objective To summarize the clinical experience in treatment of malignant tumors of renal allograft recipients. Methods A retrospective study was performed on renal allograft recipients who received immunosuppressive treatment at least half a year between 1978 and 2005. Results Fifty-eight cases of tumors were found in 1812 cases undergoing renal transplantation, 50 cases of them who had complete clinical data were included into analysis. Forty-four cases, that included 19 cases in rological system, 14 cases in digestive system, 5 cases in blood system, 6 cases in other systems, were diagnosed as having malignant tumors by pathological analysis. Most of them were treated with surgery. One-year survival rate was 68.0% after the diagnosis of malignant tumor. The longest survival time was 6.5 years. Most of the survivals possessed normal function of allograft. Conclusion Systemic follow-up is important for renal allograft recipients who suffered malignant tumors. Surgical operation is still the main therapy for those solid tumors. It is critical for the therapy of malignancies and quality of life to possess satisfactory allograft function. The strategy of treatment should take consideration of the relationship between the decrease dose of immunosuppressive agents and the preservation of allograft function.

Objective To investigate the incidence of urological malignancy in renal allograft recipients and explore the mechanism of increased incidence in China and the management. Methods A retrospective study was performed on 22 patients with urological malignancy in renal allograft recipients between 1978 and 2010. Results Twenty-two cases of urological malignancy were diagnosed by pathologic evidence, including 9 cases of transitional cell carcinoma (TCC) of bladder, 1 case of squamous cell carcinoma of bladder, 1 case of adenocarcinoma of bladder, 1 case of TCC of pelvis, 1 case of TCC of bladder and pelvis, 1 case of TCC of ureter complicated with adenocarcinoma of bladder, 2 cases of TCC of ureter, 2 cases of TCC of ureter and bladder, 3 cases of clear cell carcinoma of kidney, and 1 case of undifferentiated carcinoma of kidney. All the malignancies belonged to native organs. All the patients suffering bladder cancer had normal function of allograft. Five patients with TCC of pelvis or ureter survived and 2 cases died early after operation. All the patients suffering renal carcinoma deceased within 6 months after diagnosis. One-year survival rate was 73. 7 % after the diagnosis of urological malignancy. Conclusion Urological malignancy ranked highest in malignancy in renal allograft recipients, and rare pathological types of urological malignancy in non-renal allograft recipients are often demonstrated. The strategy of treatment should take consideration of the relationship between the usage of immunosupressive agents and the preservation of allograft function. It is critical for the therapy of malignancies to possess satisfactory allograft function. The prognosis of renal cell carcinoma is poor.

Objective To study the effect of angiotensinⅡon the expression of monocyte chemoattractant protein-1 (MCP-1) in cultured human umbilical vein endothelial cells(hUVEC) , and the effect of peroxisome proliferator- activated receptors (PPARs)?and?on MCP-1. Methods MCP-1 protein level was detected by enzyme-linked immunosorbent assay (ELISA) method, and the mRNA expression level of MCP-1 was determined by RT-PCR. Results AngiotensinⅡdistinctly increased the expression of MCP-1 in a dose-dependent manner in cultured hUVECs, and valsartan inhibited the expression of MCP-1 remarkably. Both rosiglitazone (PPAR7 agonist) and fenofibrate (PPAR?agonist) concentration- dependently reduced the expression of MCP-1 in induced by AngⅡ10-6 mol/L. Conclusions AngiotensinⅡcan increase the expression of MCP-1 evidently in hUVECs, which is inhibited by valsartan. The activation of PPARa and PPAR?can decrease the expression of MCP-1 in hUVECs.

OBJECTIVE: To observe the therapeutic effect of probucol on serum malondialdehyde (MDA) and superoxide dismutase (SOD) in patients with primary hypertension. METHODS: A randomized study was performed on 40 patients with hypertension. The patients were randomly assigned to the control (levamlodipine besylate 2.5 mg/d plus benazepril 10 mg/d, n=20) or probucol group (levamlodipine besylate 2.5 mg/d plus benazepril 10 mg/d plus probucol 500 mg/d, n=20). An additional twenty healthy people were enrolled in the study (normal group). All subjects were followed up for a period of four weeks. Lipids and hepatic/renal function were measured at baseline and after 4 weeks. The levels of serum MDA and SOD activity were assayed by chemical colorimetry, and other indices, including blood pressure, lipids and hepatic/renal function, were measured at baseline and after 4 weeks. RESULTS: Compared to the normal group, the levels of MDA in all of the hypertension patient groups were higher, SOD was lower. The antihypertensive treatment decreased serum MDA levels but increased SOD content, and probucol treatment exaggerated these effects, with greater reduction of serum MDA levels and greater increase of SOD content. CONCLUSION The treatment with probucol can improve oxidative stress in hypertension patients, resulting in reduced serum MDA levels and improved SOD activity, thus contributing agreater antihypertensive effect.
Adult ; Antioxidants ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Malondialdehyde ; blood ; Middle Aged ; Oxidative Stress ; drug effects ; Probucol ; therapeutic use ; Superoxide Dismutase ; blood

Objective To investigate the correlation between serum homocysteine (Hcy) and macrophage migration inhibitory factor(MIF) with carotid atherosclerosis and between serum Hcy and MIF ,and to study whether serum Hcy influence the carotid atherosclerosis formation by MIF .Methods 258 inpatients and outpatients were performed the color ultrasound examination to ob-serve the carotid arterial vascular anatomic form ,endomembrane circumstance ,plaque and the plaque echo nature ,and the carotid in-tima-media thickness(IMT) was measured .According to the results of color ultrasound ,the cases were divided into three groups :IMT normal group(control group) ,thickening group and plaque group .According to the plaque echo characteristics ,the plaque group was redivided into two subgroups :stable plaque group and unstable plaque group .Serum Hcy and MIF levels and biochemical parameters were measured simultaneously in all cases .The differences of serum Hcy and MIF levels were compared between groups .The correlation coefficients among serum Hcy levels ,MIF levels and IMT were calculated .Results The serum Hcy and MIF levels in the control group ,thickening group and plaque group were increased in turn ,the difference among groups was statisti-cally significant(P<0 .01);which in the unstable plaque group was significantly higher than that in the stable plaque group ,the difference between them was statistically significant (P<0 .01) .The positive correlation was found among serum Hcy levels ,serum MIF levels and IMT (r=0 .584 ,0 .562 ,0 .607 ,P<0 .01) .Conclusion The serum Hcy and MIF levels are closely related with the carotid atherosclerosis degree and the plaque stability ;the serum Hcy and MIF levels are positively correlated with the carotid arte-rial IMT ;serum Hcy is positively correlated with the MIF level ,Hcy may cause the carotid atherosclerosis formation via MIF .

Objective To analyze the efficacy and safety of losartan in the treatment of massive proteinuria in kidney transplant recipients.Methods All of the 82 patients were randomized in two groups:losartan group and control group(amlodipine group).Both of the groups were divided into two different subsets according to blood pressure control Twenty-four-hour proteinuria,serum creatinine,blood pressure and adverse effects were observed.Results Losartan and amlodipine had the similar effects on blood pressure control The 24-h proteinuria in losartan group at the end of the study was significantly lower than that at the baseline,and there was significant difference between the losartan blood pressure control subset and the losartan blood pressure un-control subseL The effective rate and significant effective rate in losartan group for massive proteinuria were higher than in control group.Conclusion T Losartan can be effectively and safely used for the treatment of massive proteinuria in renal transplant recipients independent of blood pressure.

Objective To investigate the effect of cyclosporine blood level at first year after kidney transplantation on patients with a survival time over 10 years. Methods 380 patients with functional allograft, a survival time over 10 years and long-term administration of cyclosporine A (CsA) were studied, and received CsA-based treatments. According to the blood CsA level at the first year after kidney transplantation, patients were divided into five groups: group 1, blood CsA level was above 0. 208 μmol/L (1 μmol/L = 1201.9 μg/L), group 2, blood CsA level between 0. 166-0. 208μmol/L; group 3, blood CsA blood level between 0. 125-0. 166 μmol/L; group 4, blood CsA blood level between 0. 083-0. 125 μmol/L; group 5, blood CsA level less than 0. 083 μmol/L. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine(SCr), uric acid (UA), cholesterol (CH), triglyceride (TG), alanine aminotransferase (ALT), direct bilirubin (DBil) and total bilibubin (TBil), albumin (Alb), hemoglobin (Hb), count of white blood cells and positive rate of proteinuria in 5 groups at the 1st, 5th and 10th year after kidney transplantation were analyzed. Results At the 5th year SBP in groups 1 and 2 was higher than in groups 3, 4 and 5. UA level in group 5 was lower than other groups, and Alb level in group 5 was higher than other 4 groups. Proteinuria positive rate in groups 4 and group was lower than other groups. At the 10th year after kidney transplantation,indexes among 5 groups had no statistically significant difference, except for SBP, DBP, DBil and CH in some groups. There was also no significant difference in SCr level among 5 groups at the 5th or 10th year after transplantation. Conclusion Blood CsA levels at the first year after kidney transplantation has no significant effect on long-term allograft function. But higher level of CsA (＞0. 166μmol/L) at the first year maybe predict high rate of hypertension, high blood UA and proteinuria at the 5th and 10th year after transplantation.

Malnutrition is closely related to clinical outcomes and accurate evaluation of nutritional status is the cornerstone of nutritional therapy. However, consistent diagnostic criteria for malnutrition have been absent for quite a long period. The Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in September 2018 and served as a consensus-based evaluation tool. As per GLIM criteria, evaluation of malnutrition should follow a two-step approach with nutritional screening as the first step and then malnutrition diagnosis assessment and severity grading based on etiologic as well as phenotypic metrics. Since debut, GLIM criteria have been applied in different countries, healthcare settings and populations, showing good accuracy and prognostic value for outcomes such as complications and survival. However, most of the studies are retrospective in nature and high-quality prospective studies are needed to better validate GLIM criteria. The way to steer nutritional interventions based on GLIM criteria is also worth future investigation.

Objective:To investigate the infection spectrum revealed by metagenomics high-throughput next-generation sequencing (mNGS), and to provide a reference for infection diagnosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A total of 64 patients who developed systemic or local infection symptoms after allo-HSCT in Hebei Yanda Lu Daopei Hospital from January 2018 to November 2018 were enrolled. Gene sequences of pathogenic microorganisms in blood, cerebrospinal fluid and bronchoalveolar fluid specimens were detected by using mNGS. The pathogenic microorganisms or suspected pathogens were determined based on the clinical manifestations of patients.Results:There were 97 samples of mNGS detection for 64 patients who underwent allo-HSCT. The most common gram-positive bacteria were staphylococcus haemolyticus (19 times) and staphylococcus (14 times), and the most common gram-negative bacterium was acinetobacter baumannii (8 times). The most common viruses were cytomegalovirus, EB virus and Torque teno virus (35, 22 and 23 times, respectively), and the most common fungi were malassezia globus (14 times) and candida parapsilosis (8 times). There were 3 mycobacterium tuberculosis complexes detected in 3 patients with acute myeloid leukemia who received allo-HSCT. Mycoplasma orale was detected in one patient's sputum, and none parasite was detected.Conclusion:mNGS can comprehensively reveal the infection spectrum of hematologic diseases after allo-HSCT, especially for pathogenic microorganisms that are rare or difficult to cultivate, and it can effectively help the diagnosis of clinically infectious pathogens.

Objective To analyze the chemical compounds of Shenqi Dihuang decoction by the ultraperformance liquid chromatography coupled with linear quadrupole ion trap-orbitrap mass spectrometry (UPLC-LTQ-Orbitrap-MS). Methods Warters ACQUITY UPLC HSS T3 (2.1 mm ×100 mm, 1.8 μm) was used as chromatographic column with mobile phase: 0.1% formic acid water (A)-0.1% formic acid acetonitrile (B) with gradient elution, and flow rate was 0.3 ml/min. Electrospray ion source (ESI) and an electrostatic field orbital ion trap mass analyzer were adopted, which was used to collect mass spectrometry fragment information with positive and negative ion modes, by comparing with the relative retention time of the reference substance. In addition, the fragment information of the mass spectrum was used to identify the compounds. The accurate identification of the chemical components in Shenqi Dihuang decoction was confirmed with literature. Results The study found that UPLC-LTQ-Orbitrap-MS technology could be used to identify 62 chemical components, including 13 aromatic acids, 9 flavonoids, 8 saponins, and 5 aromatic amines, 3 keto acids, 2 phenols, 1 aromatic quinone and other ingredients in Shenqi Dihuang decoction. Conclusion The identification analysis method in this study was efficient and accurate, which could be applied to the identification and analysis of chemical components in Shenqi Dihuang decoction and provided the important experimental data for the research on the material basis and mechanism.