ObjectiveTo introduce an improved implantation for urethral stents in patients with infra-sacral neurogenic voiding dysfunction and to evaluate its outcome.MethodsTwelve patients with infrasacral neurogenic voiding dysfunction were treated by implantation of urethral stent according to an improved method.The following objective parameters were used to evaluate the outcome:voiding diary,urine residue volume(URV),renal hydronephrosis and urodynamic tests.ResultsThese parameters were improved significantly after implantation:detrusor leak point pressure,voiding pressure and URV decreased,voiding volume and urine flow increased.The main complications were incontinence,difficult voiding and hematuria,but these were transient and disappeared during a week.ConclusionsThis procedure is effective with fewer complications,protects the function of upper urinary tract and improves the life quality of the patients with infra-sacral neurogenic voiding dysfunction.

Objective To investigate the effect of CYP3A5 * 3 and MDR1C3435T polymorphisms on the blood trough concentration of sirolimus in the Chinese renal transplantation recipients with stable renal function and the influencing factors for individual differences.Method 112 cases of Chinese renal transplantation recipients with stable renal function were recruited in this study.Related data of the recipients,including gender,age,height and body mass,were recoded.CYP3A5 and MDR1 genotypes were determined by the direct sequencing.Blood trough concentration of sirolimus was measured by using chemiluminescence microparticle immuno assay (CMIA).The influencing factors of individual differences in sirolimus blood trough concentration was analyzed,and the correlation of CYP3A5 * 3 and MDR1C3435T gene polymorphisms with sirolimus blood trough concentration was evaluated.Result Of the 112 cases,there were 10 cases (8.93％) of CYP3A5 * 1/* 1,49 cases (43.75％) of CYP3A5 * 1/* 3,and 53 cases (47.32％) of CYP3A5 * 3/* 3.Allele frequencies of CYP3A5 * 1 and * 3 were 30.81％ and 69.19％,respectively.There were 31 recipients (27.68％) with MDR1 3435CC,60 (53.57％) with MDR1 3435CT,and 21 (18.75％) with MDR1 3435TT.Allele frequencies for C and T at position 3435 of MDR1 were 54.46％ and 45.54％,respectively.In this study,recipients' CYP3A5 * 3 genotype was the main factor (P =0.000) of sirolimus blood trough concentration,but dose,gender,age,height,postoperative time,the level of serum creatinine,hemoglobin levels,combined use of CsA and MDR1C3435T genotype had no effects on sirolimus blood trough concentration (P ＞ 0.05).sirolimus blood trough concentration/(dose weight) in * 1/* 1,* 1/* 3 and * 3/* 3 recipients was (0.0721 ± 0.0202),(0.1055 ± 0.0395),and (0.1395 ± 0.0537) μg·L-1 ·mg-1 ·kg-1,respectively,The sirolimus blood trough concentration/ (dose weight) in * 1/* 3 recipients was 1.46 times higher than that in * 1/* 1 recipients,and that in * 3/* 3 recipients were 1.93 times higher than that in * 1/* 1 recipients.There was significant difference in sirolimus blood trough concentration/(dose weight) between recipients with different CYP3A5 * 3 genotypes (P =0.000).Conclusion The CYP3A5 * 3 gene polymorphism is closely related to the blood trough concentration/dose of sirolimus,and is the main factor of the blood trough concentration of sirolimus between individuals.

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 evaluate the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) plus oral megestrol acetate (MA) as fertility-preserving treatment in patients with early-stage endometrial cancer (EEC). Methods: In this single-center, phase II study with open-label, randomized and controlled design, young patients (18–45 years) diagnosed with primary EEC were screened, who strongly required fertility-preserving treatment. Patients were randomly assigned (1:1) into MA group (160 mg oral daily) or MA (160 mg oral daily) plus LNG-IUS group. Pathologic evaluation on endometrium retrieved by hysteroscopy was performed every 3 months. The primary endpoint was complete response (CR) rate within 16 weeks of treatment. The secondary endpoints were CR rate within 32 weeks of treatment, adverse events, recurrent and pregnancy rate. Results: Between July 2017 and June 2020, 63 patients were enrolled and randomly assigned. Totally 56 patients (26 in MA group; 28 in MA + LNG-IUS group) were included into primary-endpoint analyses. The median follow-up was 31.6 months (range, 3.1–94.0). No significant difference in 16-week CR rate were found between MA and MA + LNG-IUS groups (19.2% vs. 25.0%, p=0.610; odds ratio=1.40; 95% confidence interval=0.38–5.12), while the 32-week CR rates were also similar (57.1% and 61.5%, p=0.743), accordingly. More women in MA + LNG-IUS group experienced vaginal hemorrhage (46.4% vs. 16.1%; p=0.012) compared with MA group. No intergroup difference was found regarding recurrence or pregnancy rate. Conclusion Compared with MA alone, the addition of LNG-IUS may not improve the early CR rate for EEC, and may produce more adverse events instead.

【Objective】 Utilizing a specially engineered miR-144-GFP-H1 human embryonic stem cell (hESC) reporter line, this study leverages GFP fluorescence as an indicator of miR-144 expression to gauge the progression of erythropoiesis. The investigation is aimed at elucidating the potential roles of lncRNAs within the erythropoietic framework and conducting an initial assessment of their functional impact. 【Methods】 The miR-144/451-GFP-H1 cell line (hereafter referred to as 144-H1) was utilized for in vitro erythrocyte induction culture. The subpopulations of cells entering the erythropoiesis stage were characterized by the surface molecules CD71 and GPA. The GFP reporter gene of miR-144 served as a critical determinant to distinguish between GFP-positive cells (with a high propensity for erythropoiesis) and GFP-negative cells (with a low propensity for erythropoiesis). Transcriptome sequencing was performed on both groups to identify differentially expressed long non-coding RNAs (lncRNAs). LncRNA entries with potential for validation were selected for preliminary functional verification. The CRISPR/Cas9 gene editing technique was employed to design functional interference strategies for the targeted lncRNAs, obtaining 144-H1 cell lines with knocked-out function of the specific lncRNAs. These knockout cell lines, along with non-knockout 144-H1 cell lines, were used for parallel erythrocyte induction culture to identify differential nodes. This approach preliminarily verified their impact on erythropoiesis in an in vitro development model. 【Results】 1)The constructed 144-H1 cell line was capable of expressing GFP fluorescence upon entering the stage of in vitro erythrocyte induction, indicating the activation of miR-144/451. 2)Within the CD71, GPA double-positive group, significant differences in lncRNA expression were observed between the GFP-positive and GFP-negative subpopulations. 3) Gene editing strategies involving the deletion of sequence segments capable of effectively interfering with the function of multiple lncRNA entries were designed and verified for successful editing. In the knockout cell lines, parts of the lncRNA sequences were directly deleted. 4)In parallel validation experiments of erythrocyte induction culture, cell lines with LINC01569 knocked out exhibited significant differences in flow cytometric subpopulations and cell proliferation capabilities compared to the non-knockout cell lines: ①The knockout cell lines showed sustained high expression of GFP fluorescence. ②The proportion of the CD71-GPA double-positive group in the knockout cell lines continuously decreased during erythrocyte maturation. ③No significant expression of hemoglobin was observed in the knockout cell lines, lacking the characteristic red color. ④The cell proliferation capability of the knockout cell lines was significantly lower than that of the non-knockout cell lines (P<0.05). 【Conclusion】 The successful employment of the 144-H1 cell line facilitated an exploration into the potential functions of lncRNAs in erythropoiesis. This enables the design of more refined in vitro developmental experiments to enhance the precision in capturing lncRNA functions. Among the differentially expressed lncRNA entries, LINC01569 was preliminarily validated to play a regulatory role in erythropoiesis. The functional absence of LINC01569 severely impacts the normal differentiation and proliferation of erythrocytes. The specific regulatory mechanism of LINC01569 in erythropoiesis warrants further investigation and research.