Objective To analyze the death causes of cadaveric kidney transplantation recipients. Methods The clinical data of 1400 cases of cadaveric kidney tansplantation between 1978 and 2003 were analyzed retrospectivvely. The death rate, causes and period were analyzed among the died recipients after kidney transplantation. Results 187 patients were died after renal transplantation in this stage with the ratio being 13.36% (187/1400). The death causes contained infection, cardiocerebra l vascular diseases and hepatic failure by turns, and the ratio was 37.97% , 31.56% and 14.97% , respectively. There were 87 ( 46.5% ) death cases w ith normal transplanted-kidney function. Conclusions The leading causes of patients' death were infection, cardiocerebral vascular d iseases, and hepatic failure. About half of these patients were died with normal transplanted-kidney function.

Objective To explore the methods for treating no-functioning renal graft.Methods The management of 240 cases of non-functioning renal graft between 1978 and December 2003 was retrospectively analyzed.Results Twenty-nine recipients with renal failure one month after renal transplantation were subjected to removal of the renal graft. One year after renal transplantation, the recipients with renal failure received resection of the renal graft, 4 were treated with renal artery embolism, and 114 did not receive special treatment.Conclusion The non-functioning renal graft required removal at early stage of renal transplantation. At later stage, no symptomatic cases of post-transplanted renal failure required no management after stopping immunosuppressant. The appropriate management is reserved for the symptomatic cases.

Objective To explore the effects of miRNA-218 on renal cell carcinoma of nude mice in vivo.Methods The pcDNA3.1-miR-218 and its control negative plasmids were stably transfected into renal cell carcinoma cell line A498 and 769-P.These cells were inoculated into nude mice in different groups to observe the changes of body and tumor and to detect the expression of miR-218 in the tissues of nude mice.Results In the A498 cells + pcDNA3.1-miR-218 transfected group,the weight loss of tumor bearing nude mice after 25 days was lower than that in the control group,and the tumor volume was smaller than that in the control group after 10 days (P ＜ 0.05).In the 769-P cells + pcDNA3.1-miR-218 transfected group,the weight loss of tumor bearing nude mice was lower than that in the control group after 19 days,and the tumor volume was smaller than that in control group after 10 days (P ＜ 0.05).The expression of miRNA-218 in bearing nude mice with A498 cells or 769-P cells transfected by miRNA-218 was significantly higher than that in the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Up-regulation of miRNA-218 expression can inhibit the growth of renal cell carcinoma of nude mice in vivo.

Objective To construct a stable expression plasmids miR-218,to lay the experimental foundation for the expression and mechanism of miR-218 in human renal cell carcinoma.Methods The primers were designed by Has-miR-218 and the miR-218 fragment were amplified by PCR,and then which was connected with the carrier pcDNA3.1 (+) to build a stable expression plasmids.The recombinant plasmids were trasfected into renal cell carcinoma cell line 769-P,and the expression of miR-218 in these cells were detected.Results The plasmids were constructat successfully,which was determind by enzyme digestion and sequencing results.The constructed expression plasmids pcDNA3.1-miR-218 transfection of human renal cell carcinoma cell line 769-P,miR-218 cxpression level of cells was significantly increased after trasfected by recombinant plasmids carrying miR-218 gene (relative expression quantity was 1.64).Conclusion The miR-218 expression plasmids pcDNA3.1-miR-218 were successfully constructed,the plasmids can be applied to the study of miR-218 function and mechanism in renal cell carcinoma.

Objective To investigate the serum procalcitonin (PCT) levels in sepsis caused by the bacteria,virus and mycoplasma and explore the role of PCT in etiology diagnosis of sepsis in children.Methods Three hundreds and thirty critically ill children with sepsis caused by bacteria,virus and mycoplasma admitted in PICU of Hunan Children' s Hospital from Feb 1,2011 to Sep 1,2012 were reviewed and analyzed.The PCT levels were measured at admission and day 3.The differences in accidence of sepsis caused by bacteria,viruses and mycoplasma according to different serum PCT levels were analyzed.The differences of PCT levels at admission and day 3 in sepsic children caused by bacteria,viruses and mycoplasma were analyzed.Results The level of serum PCT in sepsis caused by bacterial infection were distinctly increased,caused by virus and mycoplasma infections was not obvious but the increases of serum PCT [0.71 (8.14)ng/ml,0.15 (1.68) ng/ml,0.28 (1.89) ng/ml].According to various PCT levels(0.05 ～ ng/ml,0.5 ～ng/ml,2 ～ ng/ml,10 ～ 300 ng/ml),the differences of accidence of sepsis caused by bacteria,virus and mycoplasma were also statistically significant(x2 =84.50,P ＜ 0.01).The PCT level of septic children caused by bacterial infection in day 3 was significantly decreased compared with that at admission [0.32 (5.68) ng/ml vs 0.71 (8.14) ng/ml] (U =19.34,P ＜0.05).Conclusion PCT plays a certain role in etiology diagnosis of sepsis in children.The increased PCT levels which can be reduced by anti-inflammatory treatment indicate the likelihood of bacterial infection and sepsis.The increase of PCT induced by viral and mycoplasma infections is not obvious,but bacterial infection can not be completely ruled out.

Objective To discuss the indication, technical points and long-term effects of endovascular embolization for non-functioning renal graft with detachable coils, and to get further evaluation of its practical value.Methods Monitored by DSA, endovascular embolization with detachable coils was performed on 11 patients with non-functioning renal graft.Results Renal arteries all had been successfully blocked in 11 cases.Good recovery without any complication was obtained.Conclusion Endovascular embolization for non-functioning renal graft with detachable coils is safe, minimally invasive and convenient, and can be used as an alternative to the resection of the renal grafts.

Objective To investigate the characteristic and the value of renal solid lesions' boundary at contrast-enhanced ultrasonography(CEUS). Methods The study included 225 patients (124 males, 101 females) with renal 239 solid lesions [133 renal cell carcinoma(RCC) and 106 benign lesions]. The enhanced mode of lesion boundary at CEUS was observed. The histopathologic pseudocapsule of RCCs was analysed.Results Enhanced modes of all lesions' boundary at CEUS were classified as: type Ⅰ , iso-enhanced boundry in whole phase, 82.85 % (198 of 239) ;type Ⅱ , a perilesional annular highly-enhanced signal at early phase,4.18% (10 of 239);type Ⅲ ,perilesional annular highly-enhanced signal in whole phase,9.62% (23 of 239) ;type Ⅳ, perilesional annular highly-enhanced signal in midium and late phase, 1.25 % (3 of 239) ;type Ⅴ ,iso-enhanced boundry in the mdium and late phase with no enhancment at early phase, 2. 09% (5 of 239). The distribution of types Ⅰ , Ⅱ , Ⅲ between groups were significant different( P=0.000, 0.046,0. 000), the type Ⅳ and Ⅴ was not ( P = 0.256,0.068). The distribution of perilesional annular highlyenhanced signal between benign and RCC groups was statistically different (x2=29. 681, P=0.000).Regared it as a diagnostic criteria of RCC,the sensitivity was 26.32% (35/133) ,the specificity was 99.06%(105/106) ,the positive predictive value was 97.22% (35/36),the negative predictive value was 51.72%(105/203) ,and the accuracy was 58.58% (140/239). The perilesional annular highly-enhanced signal was not correlated with the pseudocapsule in pathology ( P = 1. 000). Conclusions The boundary enhancement mode of renal solid lesions at CEUS was divided into five types. The perilesional annular highly-enhanced signal was important in diagnosis of RCC,which was not correlated with the pseudocapsule in pathology.

BACKGROUND: Anemia after kidney transplantation has a clinical incidence rate of 30%-40%, is the important risk factor for cardiovascular diseases and kidney failure after kidney transplantation and is also the independent prediction index of patient's death. OBJECTIVE: To analyze the factors related to anemia after kidney transplantation. RESULTS AND CONCLUSION: In the anemia group (n = 225, 27.2%, aged 26-65 years), the incidence rate of anemia in female and male patients was 23% and 37%, respectively (P < 0.05), 46 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 16 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 85.3% and kidney failure rate of 25.3%. In the non-anemia group (n = 601, 72.8%, 405 males, 196 females, aged 18-71 years), 35 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 14 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 92.1% and kidney failure rate of 12.6%. There was significant difference in above-mentioned indices between anemia and non-anemia groups (P < 0.05). These results suggest that gender, age, kidney function, digestive tract disease history, and drug application are closely related to anemia after kidney transplantation.

Since 2000,most of H5N1 subtype influenza A virus had a unique mutation of NS gene with 15base pair deletion from 263 to 277. In order to investigate the bio-characteristics of this mutation,two different NS recombinants,RWSN-248 and RWSN-m248,were generated via plasmid rescue from A/WSN/33(H1N1) and A/SD/04(H5N1). RWSN-248 had a higher viral titer than RWSN-m248 in MDCK and COS-1 cells that have an IFN response,but they had the similar growth ability in Vero cells that lack an IFN response. Both of two recombinants grew well in embryonated chicken eggs and had the similar viral titer and MDT. The results above revealed that the deletion from 263 to 277 sites of NS gene did not influence viral virulence to but decreased viral anti-IFN ability of H5N1.

BACKGROUND:Reversible posterior leukoencephalopathy syndrome is rarely reported, especial y concurrent during perioperative period of renal transplantation. Due to its clinical manifestations similar to uremia, transplant doctors are easy to ignore or not timely diagnosis reversible posterior leukoencephalopathy syndrome, thus impacting its treatment.
OBJECTIVE:To discuss the clinical manifestations, imaging features, treatment experience and prognosis of patients with reversible posterior leukoencephalopathy syndrome concurrent during perioperative period of renal transplantation, in order to improve the diagnostic rate and therapeutic effect.
METHODS:We reviewed clinical data of one case of concurrent reversible posterior leukoencephalopathy syndrome during perioperative period of renal transplantation admitted at the General Hospital of Shenyang Military Region.
RESULTS AND CONCLUSION:From the 3rd day postoperatively, the patient gradual y experienced abnormal blood pressure, blurred vision, headache, seizures, disturbance of consciousness and mental and behavioral abnormalities. Early head CT showed low density in the left frontal lobe and corona radiate;and further MRI re-examination showed flake-shaped T1 and long T2 signals in the bilateral frontal lobe, hippocampus, parietal occipital cortex, and brainstem, as wel as high signals on FLARI images at the corresponding parts. After active treatment, the clinical manifestations were improved. Retrospective analysis of clinical data of this case and review of relevant literature wil provide clinical data for the diagnosis and treatment of concurrent reversible posterior leukoencephalopathy syndrome during perioperative period of renal transplantation.