Objective To study kidney transplantation in the aged and its perioperative management. Methods Scrutinized screening of heart,lung and liver were carried out before renal transplantation for 29 patients,aged 65～84.Color Doppler B type ultrasonic inspection was used to determine the status of arteriae iliaca externa and arteriae iliaca interna.Tissue match included HLA and PRA measurement.Warm ischemia time of donor kidney was within 5 minutes and cold ischemia time 10 hours.The dose of MP was under 2.0 g during the period of operation and the immunosuppressive regimen was CsA or FK506+MMF+Pred.The general condition,blood electrolytes,whole blood CsA or FK506 concentration and immune index were monitored. Results There were 4 cases of AR,1 cases of FK506 toxicity and 1 case of lung infection.All these 6 patients were cured.1 kidney graft was removed because of thrombogenesis of renal artery.Up to now,the other 28 have been surviving with the graft functioning well for 1 to 5 years. Conclusions Abide to the indications of kidney transplantation,donor kidney of good quality and well tissue match were important in the elderly patients.With comprehensive monitoring and adequate management,kidney transplant in old patients can achieve sa tisfying outcome.Rational application of immunosuppressants and effective long term follow up are major factors for long term allograft survival.

Objective To investigate the expression and clinical significance of CDx2 and hepatocyte antigen(Hep) in gastric carcinoma.Methods The expression of CDx2 and Hep in 9 cases of nomal gastric mucosa,15 cases of small intestinal mucosa,8 cases of colon mucosa,15 cases of intestinal metaplasia of the stomach and 130 cases of gastric carcinoma were detected with immuohistochemical EnVisionTM Systems measures.Results The positive rates of CDx2 expressed in the nomal gastric mucosa were 0,small intestinal mucosa 80%(12/15),colon mucosa 87.5%(7/8),intestinal metaplasia of the stomach 86.7%(13/15),gastric carcinoma 37.7%(49/130);The positive rate of Hep was 11.1%(1/9),86.7%(13/15),12.5%(1/8),100%(15/15),55.4%(72/130) respectively.There was much higher positive expression of CDx2 in intestinal-type carcinoma than in diffuse-type gastric carcinoma(P

Objective To study the signification of p57kip2 immunostaining to distinguish molar gestations from hydropic abortions.Methods To observe the p57kip2 immunohistochemical expression in 58 cases of histological hydropic villi which were divided into complete mole(18 cases) ,partial mole(19 cases),hydropic abortion(11 cases)and undetermined hydropic abortion or molar gestations(10 cases) and in 3 normal placentas.Results Normal villi,partial mole and hydropic abortions show positive staining for p57kip2, which expressed in the nuclei of cytotrophoblast and villous mesenchyme,and complete moles show complete absence of staining in the cytotrophoblast and villous mesenchyme.According to the comparison of the diagnosis based on morphology and the one based on p57kip2 stai-ning,the later whose sensitivity is 96% (46/48) confirmed the earlier diagnosis in 58 cases studied and the later conformed to the earlier very well.Conclusion The immunohistochemical staining for p57kip2 is a valuable diagnostic mean to distinguish molar gestations from hydropic abortions and is a sensitive and specific marker for the diagnosis of complete mole.

The submucous plexus of the gastrointestinal tract in 20 guinea pigs were studied by histochemical methods for Nissl bodies and acetylcholinesterase (AChE) and immunohistochemieal technique for somatostatin (SOM). We found that some neurons in the submueous plexus were located against the lymphatic vessels or even protruded toward the lumen, and only a basement membrane separated the endotheliocytes from the neurons. Thus we refer them as "paralymphatic neurons". The neurons were spindle, pear-like or polygonal in shape and all showed AChE positive reaction, but some of them exhibited SOM positive reaction. So, the paralymphatie neurons were different in property. According to the close appositional relationship between the neurons and lymphatic vessels, we infer that this peculiar type of neurons might be similar to the "cerebrospinal fluid-contacting neurons" in the ependyma and might have the function of neurosecretion or reception of the changes of chemical composition in the lymph. Paralymphatie neurons existed mainly in small intestine, rarely in colon and were not seen in gastric corpus and pyloric region. This suggested that the neurons might play a more important role in small intestine.

Objective To explore the effects of cyclosporin A (CsA) and tacrolimus (Tac) on biological behaviors of lung cancer A549 cells in nude mice.Methods Thirty-six models of transplanted tumor in Balb/c mice were established by using lung cancer A549 cells and divided into three groups:control group,without given any immunosuppressant; CsA group,intraperitoneally given CsA; Tac group,intraperitoneally given Tac.The transplanted tumor growth curve was drawn according to the transplanted tumor volume,and the influencing ratio was calculated according to the final tumor weight.The changes in cell migration ability were observed by using Transwell system.Terminal deoxynucleotidyl transferase mediated UTP nick end labeling (TUNEL) assay was used to examine the apoptosis index of the transplanted tumor.Quantitative RT-PCR was used to detect the expression levels of Bcl-2 mRNA and Bax mRNA.Results The growth of transplanted tumor in CsA and Tac groups was faster than in control group.Final tumor volume and final tumor weight in CsA and Tac groups were greater than those in control group.The influencing ratio in CsA and Tac groups was 19％ (P＜0.05) and 25％ (P＜0.05),respectively.The migration ability was greater in CsA and Tac groups than in control group (P＜0.01).The apoptosis index of the transplanted tumor in CsA and Tac groups was lower than in control group (P＜0.05).The expression level of Bcl-2 mRNA was higher in CsA and Tac groups than in control group (P＜0.05),and that of Bax mRNA was lower in CsA and Tac groups than in control group (P＜0.05).Conclusion Both CsA and Tac can promote the growth of transplanted tumor in nuce mice bearing 549 cells and enhance the invasion forces,which is probably related with the apoptosis induction of tumor cells.

Objective To evaluate the curative effects of conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) on MMF-related chronic diarrhea in the renal transplant (RT) recipients of long-term stage following transplantation.Methods Twenty-six RT recipients with persistent and severe diarrhea,diagnosed as MMF-related diarrhea after a systemic examining procedure including macroscopic and microscopic examinations of the upper and lower gastrointestinal tracks,serology of the blood for CMV and culture of stool for the bacteria.In all the 26 recipients,the dosage of MMF was reduced to 250 mg,twice every day for 2 weeks.Those without significant improvement at the end of this period were shifted to EC-MPS at a dose of 180 mg,twice every day for 2 weeks.The EC-MPS dose was increased to 360 mg,twice every day if the symptoms were improved significantly at the third week after conversion,or EC-MPS was withdrawn if the diarrhea still existed.The dosage of EC-MPS would be reduced to 180 mg,twice every day if the diarrhea recurred in the next 3 months. The clinical symptoms,biological parameters and renal function were observed for 3 months after the conversion.Results ( 1 ) All the 26 recipients were switched to EC-MPS because of the persistent existence of diarrhea after reduction of MMF.After conversion,the diarrhea disappeared completely in 19 out of the 26 recipients in 2 weeks and 2 patients also showed significantly improvement of diarrhea with the total efficiency being 80.8％ (21/26).In the rest 5 cases,EC-MPS was withdrawn at the second week; (2) The disturbance of internal environment was improved significantly following the EC-MPS conversion.Serum potassium,sodium and TCO2 were elevated to normal level.The benefit was predominantly observed in the recipients with moderate to severe proteinuria.The 24-h urinary protein secretion was significantly reduced from 0.76±0.48 to 0.46±0.53 (g/24 h) (P＜0.05) at the third month.Conclusion In RT recipients with MMF-related chronic diarrhea after long-term stage following renal transplantation,switching MMF to EC-MPS can significantly alleviate the diarrhea and rectify the imbalance of internal environment of the recipients.

ObjectiveTo explore the expression of Glut1, HIF-1α and Ki-67 in hepatocellular carcinoma (HCC) and their relationship between their expression and clinicopathological features.MethodsImmunohistochemical study (EnVision method) for Glut1, HIF-1a and Ki-67 were performed on tissue microarray which consisted of 171 cases of HCC, 55 cases of adjacent non-neoplastic liver tissues, and 22cases of normal liver tissues.ResultsThe expression rate of Glut1 ,HIF-1α and ki-67 in 171 cases of HCC was 15.2％, 19.9％ and 66.1％, respectively, which was much higher than that in the adjacent non-neoplastic liver tissues (1.8％ ,1.8％and 5.5％) and normal liver tissues(all negative).The expressions of Glut1 and HIF-1α were positively correlated with the differentiation degree of HCC and TNM stage(P ＜0.01, P ＜0.05).The expression of ki-67 was positively correlated with the differentiation degree of HCC.There was a significant positive correlation between the expressions of Glut1 and HIF-1α in HCC (r1 =0.553, P ＜0.05), the expressions of Glut1 and HIF-1α were positively correlated with ki-67(r2 =0.560,r3 =0.613, P ＜0.05).ConclusionsGlut1, HIF-1α and ki-67 may play a role in the tumorigenesis and progression of HCC in some degree.Combined detection of Glut1, HIF-1α and Ki-67 may be helpful to judge the degree of malignancy and potential metastasis and evaluate the prognosis.

To investigate the efficacy and safety of minimal y invasive endovascular techniques treatment of hydronephrosis in pregnancy complicated by infection.
65 cases of pregnancy hydronephrosis coinfected patients with minimal y invasive endovascular treatment. Patients were fol owed up for 3-12 months, compared with 48 patients with the same period of conservative treatment .
Ureteral perforation and other surgery-related complications occurred in 65 patients in the observation group has not occurred. The patient's duration of hospitalization、the recurrence rate of postoperative infection, antibiotic duration of treatment, fever days were significantly lower than the control group(P<0.05).
Compared with conservative treatment, minimal y invasive endovascular technical treatment of gestational hydronephrosis co-infection with faster recovery, shorter hospital stay, can significantly reduce the number of days of fever patients and reduce the number of days of antibiotic use, can be used as conventional means of treatment of gestational hydronephrosis infection combined conventional.

Objective:To assess the possibility of suicide in setting condition among urban and rural residents samples in northern China.Methods:By randomly sampling,1007 persons aged 18 years or older were selected from 10 urban neighborhoods in Beijing and from 10 rural village in Hebei province.The Survey Schedule of Atti-tudes in China in which 24 negative life events were listed,and the possibility of committing suicide was asked to the subjects when they encountered the supposed events.Results:The rates of thinking about committing suicide when encountered the supposed life events were 65.2% of incurable illness,62.0% of burden on other and no future hope,61.2% of drug dependence,57.3% of large debt due to gambling,54.2% of being raped, 51.6% of severe depression,50.7% of being elderly and no family to provide support.Only 14.6% of the ur-ban and rural residents would not consider suicide when encountered any type of supposed problems.Conclusion:There is higher possibility of considering suicide in urban and rural residents when encountered negative life events, so it is important to give support to the residents with one or more life events.

This study compared two techniques of artery anastomoses,renal artery to the ex- ternal iliac artery (ESA) and to the internal iliacartery (EEA) in renal transplantation.The operation time and the incidence of anastomotic stenosis was cut down significantely in ESA group.The blood flow in grafts has no difference in two groups with normal renal function.The utilization rate of grafts with multiple arteries was higher (94.4%) in ESA group.Back bench surgery for artery repain,cold ischemia time and renal damage were reduced in ESA group.