OBJECTIVEEplets mismatch based on HLAMatchmaker software evaluates the clinical application of kidney transplantation.

METHODSIn 239 cases of renal transplant,merits of methods of the traditional HLA six antigen matcheing criteria, cross reaction groups standard and Eplets mismatch based on HLAMatchmaker standard were compared respectively.

RESULTSThe number of mismatchs with three methods in 239 cases, were grouped according to low-high mismatchs. The results revealed that HLAMatchmaker algorithm could significantly increase the number of low mismatchs group 54 (22.6%), compared with the HIA group 19(7.9%) and CREGs group 32 (13.4%). The comparison was discovered statistical significance among the three groups (P<0.001), so the comparison between each group was.

CONCLUSIONHLAMachmaker of donor-recipients matching, is a more efficient, time-saving and high sensitivity matching solution to allograft renal transplantation.

Adolescent ; Adult ; Aged ; Female ; Histocompatibility Testing ; methods ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Software ; Transplantation, Homologous ; Young Adult

OBJECTIVETo Assess therapeutic effect of ear point taping and pressing therapy combined with acupoint-injection on residual neuralgia of herpes zoster.

METHODSOne hundred and sixteen cases were randomly divided into a comprehensive group (n = 60) and a medication group (n = 56). The medication group were treated with routine western medicine, and the comprehensive group with ear point taping and pressing therapy combined with acupoint-injection besides the routine western medicine. Auricular points selected for ear point taping and pressing were Shemen, Neifenmi (endorine), Pizhixia (subcortex), Gan (liver), Dan (gallbladder), Fei (lung) and corresponding auricular points to the lesion parts, with the two ears alternatively used, pressing each day; points selected for point-injection of VitB12 were Zusanli (ST 36), Neiguan (PC 6), Quchi (LI 11), Taichong (LR 3). The pain degrees, the time of pain alleviation and pain ceasing of the patient were regularly recorded.

RESULTSThe average time of pain alleviation and pain ceasing of the patient in the comprehensive group were significantly shorter than those in the medication group (P < 0.01). The cured rate and the cured and markedly effective rate were 60.0% and 83.3% in the comprehensive group, and 28.6% and 50.0% in the medication group, with significant difference between the two groups (P < 0.05).

CONCLUSIONEar point taping and pressing therapy combined with acupoint-injection is effective and safe for treatment of residual neuralgia of herpes zoster.

Acupuncture Points ; Acupuncture, Ear ; methods ; Adult ; Aged ; Female ; Humans ; Injections ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neuralgia, Postherpetic ; therapy

OBJECTIVETo discuss the method, the advantages and disadvantages of endoscopic thyroidectomy.

METHODSEndoscopic thyroidectomy via areola of breasts approach was performed in 150 patients, including 41 cases of thyroid adenoma, 64 cases of nodular goiter, 40 cases of Graves' disease, and 5 cases of thyroid carcinoma.

RESULTSThe endoscopic thyroidectomy was successfully carried out in 144 cases, including tumor dissection in 32 cases, one lobe partial thyroidectomy in 54 cases, two lobe partial thyroidectomy in 19 cases, subtotal thyroidectomy in 37 cases of Graves' disease, and radical thyroidectomy in 2 cases of thyroid carcinoma. The operative time length ranged from 50 to 270 min (mean 80 min). There were no complications such as damage to recurrent laryngeal nerve or parathyroid glands. Postoperative hospital stay ranged from 3 to 7 days (mean 4 days). The post-operative following-up for 1 approximately 13 months indicated that all the patients were satisfied with the cosmetic results and the same curative effects as conventional surgery were obtained. However, the operations were converted into open surgery in 6 cases.

CONCLUSIONSEndoscopic thyroidectomy is a safe and effective method of thyroid surgery. Since all the minimal incisions are on concealed parts of the body, the obvious cosmetic effect of this method is guaranteed.

Adolescent ; Adult ; Endoscopy ; Female ; Follow-Up Studies ; Graves Disease ; surgery ; Humans ; Male ; Thyroidectomy ; methods ; Treatment Outcome

OBJECTIVETo investigate the safety and efficiency of the disposable circumcision suture device (DCSD) in the surgical treatment of phimosis and redundant prepuce.

METHODSWe randomly assigned 249 outpatients with phimosis or redundant prepuce to be treated with DCSD (n = 129) and by conventional circumcision (CC, n = 120), respectively. Then we compared the safety and efficiency of the two strategies.

RESULTSComparisons between DCSD and CC showed that the operation time was (4.02 +/- 0.69) vs (30.8 +/- 4.05) min, blood loss was (1.07 +/- 1.29) vs (8.72 +/- 2.15) ml, intraoperative pain score was 0.81 +/- 0.81 vs 2.42 +/- 1.15, 24-hour postoperative pain score was 1.84 +/- 1.02 vs 4.99 +/- 1.36, postoperative complication rate was 13. 95% (18/129) vs 9.17% (11/120), wound healing time was (13.99 +/- 9.06) vs (17.48 +/- 3.49) d, satisfaction with the penile appearance was 98.4% (127/129) vs 95% (109/120), and treatment cost was (2215.62 +/- 17.67) vs (576.47 + 15.58) Y RMB. DCSD exhibited obvious superiority over CC for shorter operation time, less blood loss, milder intraoperative pain, sooner wound healing, and better penile appearance, but it also had a higher rate of postoperative complications (P > 0.05) and involved more treatment cost than the latter (P < 0.05).

CONCLUSIONThe disposable circumcision suture device affords ideal clinical effects and therefore deserves clinical popularization.

Circumcision, Male ; instrumentation ; Disposable Equipment ; Follow-Up Studies ; Humans ; Male ; Phimosis ; surgery ; Surgical Staplers ; Treatment Outcome

OBJECTIVETo investigate polymorphisms of killer cell immunoglobulin-like receptor gene (KIR) in renal transplant recipients from southern Zhejiang.

METHODSKIR genotypes were analyzed by PCR-SSP in 416 renal transplant recipients, and the genotype frequencies were compared with populations from Eastern China and worldwide.

RESULTSAll 16 known KIR genes were detected in the renal transplant recipients, and KIR2DL4, 3DL2-3, 3PD1 were found in all. As a pseudogene, 2DP1 has a high genotype frequency (99%). The frequencies of KIR2DL1, 2DL3, 3DL1, 2DS4 have ranged from 92.1% to 98.8%. Compared with 11 groups in Eastern China and other countries, the KIR2DL2 phenotype frequency was higher (34.6%) than those of Shanghai, Zhejiang and Jiangsu populations (P<0.05). Among 41 genotypes, three have not been reported previously. The most common genotype was AA1, with a frequency of 43.51%, which was significantly lower than those of Jiangsu and Northern Zhejiang.

CONCLUSIONRenal transplant recipients from southern Zhejiang share similar features with Eastern China Han population with regard to KIR polymorphisms, but also have unique frequencies for KIR genotypes.

Adolescent ; Adult ; Aged ; China ; Female ; Gene Frequency ; Genotype ; Humans ; Kidney Transplantation ; methods ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptors, KIR ; genetics ; Young Adult

To establish a fluorescent quantitative PCR method (FQ-PCR) with TaqMan probe for simultaneous detection of polyomavirus (BKV) and cytomegalovirus (CMV) and to evaluate its clinical application in the renal transplantation recipients. The conservative sequences of BKV and CMV were targeted and amplified by nested PCR technique. The PCR products were cloned into the plasmids pcDNA3. 1(+). The recombinant plasmid containing target sequences of BKV and CMV were constructed as external standards. The TaqMan-based assay was optimized. For evaluating the assay, the sensitivity was determinated by diluted standard (5 X 103-10icopies/mL), and the specificity was verified by negative control and positive control, and the precision was assessed by intra-assay coefficient of variation (ICV) through detecting standard repeatedly (20 times). A total of 480 blood samples of renal transplantation recipients were used to detect BKV and CMV DNA simultaneously with FQ-PCR, and the concentrations of FK506 were measured by ELISA. The association of DNA copy and concentrations of FK506 was analyzed. The cloned target BKV and CMV DNA was confirmed by sequencing and analysis. The sensitivity of the FQ-PCR assay reached 5 X 103 copies/ml in detecting BKV or CMV DNA. Control DNA verified the assay specifically detecting target DNA. The precision of the assay to quantif target DNA copies was acceptable (Intra-assay CV was 3.44% for BKV and 2.23% for CMV; Inter-assay CV was 4. 98% for BKV and 3.76% for CMV;). Of 480 samples, 130 samples (27. 08%) were CMV DNA positive, significantly higher than the BKV DNA positive (13.33%, 64/480, P<0.05). The positive BKV or CMV DNA was found to be associated with high concentrations of FK506 (P<0. 05). In conclusion, the developed real-time PCR assay for detecting both CMV and BKV DNA simultaneously was s high sensitive, precise and time-effectiveand could be applied in the monitoring of the CMV and BKV infection in the renal transplantation recipients.
Adolescent ; Adult ; Aged ; Conserved Sequence ; Cytomegalovirus ; genetics ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; virology ; DNA, Viral ; blood ; Female ; Humans ; Immunosuppressive Agents ; blood ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Polyomavirus ; genetics ; isolation & purification ; Polyomavirus Infections ; diagnosis ; virology ; Real-Time Polymerase Chain Reaction ; methods ; Reproducibility of Results ; Sensitivity and Specificity ; Species Specificity ; Tacrolimus ; blood ; Time Factors ; Tumor Virus Infections ; diagnosis ; virology ; Viral Load ; Young Adult

OBJECTIVETo evaluate the effects of antiarrhythmic peptide (AAP10) on ventricular arrhythmias in rabbits with healed myocardial infarction (OMI).

METHODSThirty rabbits were randomly divided into three groups (n = 10 each): Sham group, left thoracotomy was performed without coronary ligation; OMI group and OMI + AAP10 group, the circumflex coronaries were ligated. Three months post operation, the electrophysiological and antiarrhythmic effects of AAP10 were assessed in the arterially perfused rabbit left ventricular wedge preparation. Sham and OMI group were perfused with Tyrode's solution and OMI + AAP10 group was perfused with Tyrode's solution + AAP10 (80 nmol/L). Transmembrane action potentials were recorded simultaneously from endocardium and epicardium together with a transmural ECG by use of 2 separate intracellular floating microelectrodes. The stimulus-response-interval (SRI) of the epicardium and the incidence of ventricular tachycardia (VT) were observed. Whole heart and left ventricular weights, the left ventricular thickness at infarct border zone were measured.

RESULTSWhole heart and left ventricular weights as well as the left ventricular thickness at the infarct border zone significantly increased post infarction. VT was induced in 8 out of 10 rabbits in OMI group and in 2 out of 10 rabbits in OMI + AAP10 group (P < 0.05). SRI was also significantly shortened in OMI + AAP10 group compared to OMI group [SRI-1: (20.59 +/- 0.79) ms vs. (28.71 +/- 0.55) ms; SRI-2: (30.42 +/- 0.74) ms vs. (38.67 +/- 0.49) ms, all P < 0.01]. However, the action potential morphology and duration were similar between OMI and OMI + AAP10 groups.

CONCLUSIONThe antiarrhythmic peptide (AAP10) can increase gap junctional intercellular conductance without affecting the action potential morphology and duration and decrease the incidence of inducible ventricular tachycardia.

Animals ; Arrhythmias, Cardiac ; etiology ; prevention & control ; Male ; Myocardial Infarction ; complications ; physiopathology ; Oligopeptides ; pharmacology ; Rabbits ; Random Allocation

Objective Few studies are reported on the relationship of subclinical hypothyroidism ( SCHT ) with visfatin and endothelin .This study aimed to investigate their relationship in patients with cerebral infarction . Methods A total of 200 cerebral in-farction patients treated in The Second Affiliated Hospital of Hainan Medical University from January 2011 to July 2017 were divided in-to a control ( with normal thyroid function , n=40 ) , a mild SCHT ( with thyroid-stimulating hormone TSH <10 mIU/L, normal free triiodothyronine FT3 and normal free thyroxine FT4, n=60), a se-vere SCHT (with TSH≥10 mIU/L, normal FT3 and normal FT4, n=60) , and a clinical hypothyroidism ( CHT ) group ( with TSH ≥4 mIU/L, decreased FT3 and decreased FT4, n=40).The mild SCHT patients were subdivided into medication group A and non-medication group A, and the severe SCHT patients into medication group B and non-medication group B, 30 in each group, those in the medica-tion groups A and B treated by routine therapy plus oral levothyrocine , and those in the non-medication groups A and B by routine ther-apy only.We recorded the age, gender, body mass index, blood pressure, blood glucose, blood lipid, and thyroid function of the pa-tients, and compared the levels of visfatin and endothelin among different groups . Results The level of visfatin was significantly ele-vated in the severe SCHT and CHT groups as compared with the controls ([46.3±10.1] and [49.5±13.6] vs [40.2±9.7] ng/mL, P<0.05), and so was it in medication group B as compared with non-medication group B at 6 months after treatment ([42.9±6.4] vs [39.3±5.5] ng/mL, P<0.05). Conclusion Visfatin is closely related with thyroid hormone in cerebral infarction patients with se -vere subclinical hypothyroidism .Examination of thyroid function is necessary for cerebral infarction patients for the sake of early detec -tion of severe subclinical hypothyroidism and timely intervention .

Objective To investigate efficacy and safety of biliary metallic stent placement via endoscopic retrograde cholangiopancreatography (ERCP) for malignant extrahepatic biliary obstruction. Methods According to different methods, 40 patients with malignant biliary obstruction were divided into PTCD group and ERCP group. Patients in PTCD group received percutaneous puncture bile duct drainage (PTCD) treatment, patients in ERCP group received placement of metal stents under ERCP. Results The survival time of the two groups were significant difference (P < 0.05). Postoperative biliary patency time in ERCP group was significantly longer than that in PTCD group, the difference was statistically significant (P < 0.05). One week later, the index for liver function of ERCP group was significantly better than that in PTCD group (P < 0.05). Additionally, the incidence of complications of PTCD group amd ERCP group was 30.0% and 10.0%, respectively. The complication rate of ERCP group was significantly lower than PTCD group (P < 0.05). Conclusion The effect of ERCP stent implantation is similar to that of PTCD in the treatment of malignant biliary obstruction. However, after ERCP, the time of biliary tract patency is longer with less complications and the index of liver function is recovered quickier than that after PTCD. Therefore, for the patients with malignant extrahepatic biliary obstruction, ERCP holds better clinical efficacy and safety.

Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs). Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively. Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found. Conclusion B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs.