Objective To investigate the risk factors for delayed graft function (DGF) recovery in the recipients of kidney transplantation after the operation. Methods The data of 209 recipients who received kidney transplantation during January 2005 to March 2007 were analyzed retrospectively. The DGF group comprised of 47 cases. 162 cases without DGF constituted the control group. Chi-square analysis method was employed to look for the risk factors of DGF, including warm ischemia time ≥10min, hypovolaemia in the recipient, acute tubular necrosis (ATN), nephrotoxicity of calmodulin inhibitors, acute rejection (AR), 12h ≤ cold ischemia time ≤ 24h, sex, age ≥ 50, the modus of dialysis, the number of times of transplantation, human leucocyte antigen (HLA) zygosity, urinary fistula or obstruction of ureter during early period after operation, blood-transfusion before transplantation and hepatitis virus infection. Then Logistic regression analysis was used to assess and rank the relative risk of potential variables. Results The incidence of DGF was 22.5%(47/209). All patients recovered within 20.8?10.3 days except 2 cases due to AR and 1 case due to graft phlebothrombosis. The relative risk factors include AR, ATN, nephrotoxicity of calmodulin inhibitors, recipient hypovolaemia and warm ischaemia time ≥ 10min. Conclusion The ranking of risk factors is as following, ATN, nephrotoxicity of calmodulin inhibitors, recipient hypovolaemia, AR and warm ischaemia time ≥ 10min, according to decrement of the coefficient correlation. It is very important to comprehend the risk factors thoroughly in order to prevent them effectively.

Objective To analyze the clinical data of living related donor kidney transplantation,and to evaluate the related problems including the donor selection and safety,the surgical approach of living donor nephrectomy,preoperative intervention,and the relation of type matching with transplantation result.Methods Data of 30 cases of living donor kidney transplantation during 07/2002 to 07/2007 were studied retrospectively.29 cases were primary transplantation and only in one patient the transplantation was repeated,2 patients secured their transplants from the spouse,while in 28 cases transplants were donated by relatives.The blood type of all the patients was identical with an exception in 2 cases,in whom the blood type was compatible.The HLA matching results were:1 case with no-mismatch,3 cases with 4-loci mismatch,13 cases with 2-loci mismatch and 13 cases with 1-locus mismatch.The kidney was obtained with open nephrectomy in 21 cases,and in 9 donors the was harvested laparoscopically.In the 30 cases,one right kidney was donated,and the left kidneys were donated in other 29 cases.Triple-combined immunosuppressive protocols consisted of calcineurin inhibitors(CNI),MMF/Aza and steroid.Results Except in one case the allograft was removed for hyperacute rejection,and in one recipient who was again retransplanted with a cadaveric kidney due to dysfunction of transplanted kidney,28 recipients recovered smoothly in 6.3?8.0 days.In 4 cases infection with cytomegalovirus after the surgery occurred,but recovered after anti-virus treatment with ganciclovir.One patient suffered from urinary leakage,and recovered after adequate drainage,nutritional support and infection prevention.Two patients suffered from acute rejection in the first month after transplantation and reversed after hormone stosstheraphy.All donors recovered.The renal function also recovered.Conclusion Both the strict selection of donor and the overall preoperative evaluation of the donor and recipient are critical for the success of transplantation.Living relative donor kidney transplantation is worth of popalarizing,as it has preferable HLA match,short waiting time and renal ischemia time,and the source of donor kidney is expanded.

Objective To evaluate the multi-slice spiral CT scan of liver dynamic dual-phase three-dimensional vascular imaging portal phase clinical value. Methods 80 cases in clinic, who were patients with liver function and imaging diagno- sis of liver and portal hypertension in liver cirrhosis, and 20 cases of healthy persons were carried out multi-slice spiral CT dual-phase scanning. The workstation used volume rendering techniques (VR) and maximum density multi-planar recon- struction technique for reconstruction. Results The hepatic arterial phase VR image and MIP MPR images can clearly show the celiac trunk, splenic artery, hepatic artery or artery and its branches, including 2-3 grade tumor blood supply variation of blood vessels and blood vessels, the portal venous phase, VR images and MIP MPR images clearly show the 1-6 level structure and the portal vein and hepatic vein branches of 1-3, with strong three-dimensional sense of space. Conclusion The multi-slice spiral CT three-dimensional reconstruction of portal vein imaging is a fast and effective non-invasive an- giography techniques, contributing to the clinical choice of reasonable efficacy of treatment programs and follow-up.

Objective To investigate the effect of C4d deposition in peritubular capillary (PTC)in chronic allograft nephropathy (CAN) on prognosis and intervention of renal transplantation recipients. Methods All the cases who received the renal graft biopsy due to diagnosis of CAN from January 2000 to August 2008, and had the 2-year follow-up data were included in the study. The clinical data were analyzed according to the C4d deposition in PTC. Results Among 86 cases 39 cases were C4d positive (C4d+ group) and the remaining 47 cases were negative (C4d group). There was no significant difference in sex, age, donor source, transplant times, time after biopsy, the panel reactive antibodies (PRA) level between two groups (P＞0. 05). Before intervention, there was no significant difference in serum creatinine (Scr) and 24 h urinary protein between two groups (P＞0. 05). At the end of 2-year followed-up period, graft loss rate and urinary protein levels in C4d+group were significantly higher than in C4d- group (P＜0. 05). Before intervention, the incidence of blood lipid disorder and hypertension was higher in C4d- group (P ＜ 0. 05 ), but no significant difference was found in uric acid and blood sugar levels (P＞0. 05). At the end of 2-year followed-up period, there was no significant difference in blood glucose, uric acid, blood pressure and lipid profile (eliminating renal lost cases) between two groups (P＞0. 05). Conclusion The patients with CAN and C4d+ means the involvement of chronic humoral rejection and have poor clinical results. Effective intervention against humoral immune response can improve renal allograft survival.

To estimate the tolerance limit and the tolerance interval of disease incubation,under the theory that the observations(samples)were subject to Poisson distribution,the tolerance limits and tolerance interval of disease incubation were calculated based on beta-distribution with integer parameter.Expressions on the relation were obtained,including the statistics on tolerance limits of both minimum and maximum orders while the tolerance was the difference between minimum and maximum order statistics and the parameters of Poisson distribution on the sample size.Using the incomplete observations as an example,reasonable unit of sample size was considered and chosen.

Aortic Aneurysm, Abdominal ; surgery ; Endovascular Procedures ; adverse effects ; Humans ; Intestinal Fistula ; diagnosis ; etiology ; Male ; Middle Aged

Angiofibroma ; pathology ; Humans ; Soft Tissue Neoplasms ; pathology

Transforming growth factor-?1 (TGF-?1) was reported to play an important role in the pathogenesis of asthma in many stu-dies.It can stimulate the growth of fibroblast and give rise to fibrosis of lung tissues.Many scholars think that TGF-?1 is closely related to airway remodeling.It is a breakthrough to aim at TGF-?1 to find a way to intervene remodeling in asthma.Glucocorticoid (Dexamethasone and Budesonide) can have an impact in some extent to airway remodeling.In addition,interferon-? and some traditional chinese medicine such as ligustrazine,tripterygium wilfordii and ginkgo maybe effective,they all may ameliorate the progression of airway remodeling following redu-cing partial airway TGF-?1 expression.

Objective: To explore the mechanism of acupuncture in regulating cognitive deficits in insomnia rats by observing the effect of acupuncture on microglia in thalamic reticular nucleus (TRN). Methods: Thirty rats were randomly divided into a control group, a model group and an acupuncture group, with 10 rats in each group. The insomnia model was established by intraperitoneal injection of para-chlorophenylalanine (PCPA) once a day for 2 d. Rats in the control group were intraperitoneally injected with the same amount of normal saline. Rats in the acupuncture group received acupuncture at Neiguan (PC 6) and Zusanli (ST 36) for 5 consecutive days. The CLOCKLAB 2 data acquisition system was used to dynamically observe the sleep of the rats throughout the experiment. The cognition of rats was evaluated by event-related potentials (ERPs). After intervention, brain tissue was extracted. Immunofluorescence was used to test the fluorescence expression in TRN region. The concentrations of interleukin (IL)-1β and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay. Results: After intraperitoneal injection of PCPA suspension, the spontaneous activity in light period of rats in the model group and acupuncture group increased significantly compared with the control group (both P<0.01). After acupuncture treatment, the rats in the acupuncture group had much less spontaneous activity during the light period than those in the model group (P<0.01), and the results indicated that acupuncture could effectively improve the sleep quality of insomnia rats. Compared with the control group, rats in the model group showed that the P3 latency, the average optical density of microglia, and the concentrations of IL-1β and TNF-α increased significantly (all P<0.05), and the P3 amplitude decreased significantly (P<0.01). Compared with the model group, rats in the acupuncture group presented that the P3 latency, the average optical density of microglia, and the concentrations of IL-1β and TNF-α were significantly decreased (all P<0.05), and the amplitude of P3 was significantly increased (P<0.05). Conclusion: Acupuncture possesses an ability to improve the cognitive state in insomnia rats. The mechanism may be related to inhibiting the microglial activation, diminishing the levels of pro-inflammatory mediators like IL-1β and TNF-α, and promoting the recovery of central nervous system function.