Objective To investigate the clinical effect and safety of kidney transplantation from donors with severe hand-foot-mouth disease (HFMD).Methods Five cases of kidney transplantation from three donors with HFMD between Jan.2014 and Dec.2016 were analyzed.The age of three donors was 2 years,2 years and one month,and 3 years and 11 months respectively,and body weight was 11 kg,10 kg and 15 kg respectively.The age of recipients ranged from 26 to 41 years and weight from 50 to 59 kg.Single kidney transplantations were performed on 4 cases,and dual separating kidney transplantation on one case.Results One case of the transplantations was failure due to the allograft artery thrombosis.The rest 4 cases gained satisfied clinical effect.None of the 5 cases showed any symptoms associated with HFMD.Conclusion The clinical effect of kidney transplantation from donors with severe HFMD is satisfactory.The organs from donors with severe HFMD could only be used by adult recipients.

Objective To explore the use of marginal kidneys from DBD (donation after brain death) donors and the indication for adult dual kidney transplantation.Methods Two pairs of graft kidneys were procured from two marginal adult donors.Dual kidney transplants were performed in two recipients.In each recipient,two kidneys were implanted in unilateral site of right lower quadrant and placed extraperitoneally,two separate extravesical ureterneocysto-anastomoses were performed.Results Delayed graft function (DGF) combined with acute rejection occurred in two cases,and all two cases recovered after treatments.Lymphocele and hematoma occurred in one case.No graft embolism and no urinary leak happened.Conclusions Adult dual kidney transplant offers an important use of kidneys from marginal donors to increase the number of organs available for transplantation.

Parasitism characteristics of spirometra mansoni sparganum in the living donor kidney are analyzed by present cases and relevant literatures. A female aged 49 years voluntarily donated a kidney to her son. Results of healthy evaluation were accorded with the standards of living donor kidney. During repairing kidney, a sliver cyst was found in the adipose capsule on the kidney ventral surface, near to the renal hilum. The cyst was incised, and a ivory white girdle-shaped worm was obtained. After identification, the worm was identified spirometra mansoni sparganum (living body). Pathological examination showed that the cyst developed granulomatous inflammation, combined with neutrophil and eosinophilic granuiocyte infitration. Following surgery, the donor and recipient were treated with praziquantel. No proglottid or worm ovum was detected by dung detection within 3 months, without any discomfortable symptom. The infection mode and pathway may be by eating unmatured paratenic host meat or infected cyclops. The donor and recipient should be examined for parasitic infection of sparganosis mansoni prior to transplantation. No significant symptom could be detected following parasitism of sparganosis mansoni in the kidney, so it was seldom found. Worm ovum was examined in feces, which could be the evidence for sparganosis mansoni and for case history inquisition. Eosinophilia in the blood always indicated that chronic parasitic infection. Zoogenetic infection test could be tested when necessary. Sparganum antigen could be used for various immunological tests, which could provide evidence for auxiliary diagnosis of immunology. The diagnosis was usually confirmed by obtaining a polypide by surgery or histological examination. CT scanning and magnetic resonance imaging have diagnostic value of renal sparganosis mansoni.

BACKGROUND: Post-transplantation diabetes mellitus has the same characteristics as type II diabetes mellitus; however, correlation between human leucocyte antigen (HLA) and post-transplantation diabetes mellitus remains unclear among Han population in Hunan and Jiangxi provinces. OBJECTIVE: To analyze the correlation between HLA and post-transplantation diabetes mellitus, to determine predisposing genes and protecting genes of post-transplantation diabetes mellitus, and to provide reference data for personalized medicine of post-transplantation diabetes mellitus. DESIGN, TIME AND SETTING: A survey analysis was performed at Department of Urological Organ Transplantation, the Second Xiangya Hospital of Central South University from May 2007 to July 2008. PARTICIPANTS: Patients with kidney transplantation selected from Department of Urological Organ Transplantation, the Second Xiangya Hospital of Central South University between 2003 and 2008 were followed-up on individual information, testing results before and after transplantation, and zygosity. Among 195 included cases, there were 22 patients with post-transplantation diabetes mellitus and 173 with non-post-transplantation diabetes mellitus. Methods: METHODS: χ~2 was used to compare frequency of HLA antigen between post-transplantation diabetes mellitus and non-post-transplantation diabetes mellitus groups. The 195 patients were divided into ciclosporin A group and tacrolimus group according to immunosuppressive regimen, and the incidence of post-transplantation diabetes mellitus were compared usingχ~2 test. All the patients were then divided into elderly group (age ≥ 40) and low-age group (age < 40), and the incidences of post-transplantation diabetes mellitus were calculated and compared usingχ~2 test.MAIN OUTCOME MEASURES: Following-up was performed including age, blood pressure, urine volume, blood and urine routine test, liver and kidney function, blood glucose, and blood drug level. RESULTS: HLA-A30 and HLA-DR7 might be the predisposing genes of post-transplantation diabetes mellitus in south China; however, protecting genes were not found. Low dosage and low blood drug level of calcineurin inhibitors were applied in this study, and there was no significant difference in the incidence of post-transplantation diabetes mellitus between ciclosporin A and tacrolimus groups (P > 0.05). The incidence of post-transplantation diabetes mellitus in elderly group was significantly higher than that in low-age group (P < 0.05).CONCLUSION: HLA-A30 and HLA-DR7 might be the predisposing genes of post-transplantation diabetes mellitus in south China; therefore, they should be paid much attention on levels of blood glucose and urine glucose after transplantation so as to adjust the types and dosages of immunosuppressive drug in time. Low-dosage and low-concentration tacrolimus was not increased incidence of post-transplantation diabetes mellitus remarkably. However, the incidence of post-transplantation diabetes mellitus in the elderly patients was high; moreover, the incidence of cardio-cerebrovascular disease was also high. Therefore, post-transplantation diabetes mellitus might easily cause the onset of cardio-cerebrovascular disease. It was important for elderly patients to monitor blood glucose and urine glucose levels and set up an individual immunosuppression program following transplantation.

Objective To quantitatively study the distance between the left atrial posterior wall and the descending aorta(DLD)in the normal fetal four-chamber view using fetal echocardiography.Methods The distances between the left atrial posterior wall and the descending aorta in end-systole (DLDs) and in end-diastole(DLDd) were measured in a standard apical four-chamber view using fetal echocardiography in 300 normal fetuses.The gestation ages ranged from 20 to 40 weeks.Fetal non-cardiac biometric parameters included femoral length(FL),biparietal diameter(BPD) and gestation age (GA) based on menstrual age. The correlation between DLDs,DLDd and non-cardiac biometric parameters were analyzed.Results In normal fetuses,the DLDs was (0.32±0.08)cm with a range of 0.19 -0.48 cm,the DLDd was (0.43 ± 0.10)cm with a range of 0.25-0.62 cm.The DLDs and DLDd increased with the growth of GA,and were correlated with GA and BPD and FL significantly (r = 0.545,0.556,0.574,0.530,0.563 and 0.576, respectively,all P <0.001).The linear regression equations between DLDs,DLDd and GA,BPD,FL were:Y =0.009GA+0.041 ,Y =0.038BPD+0.028,Y =0.044 FL+0.073,Y =0.01 1 GA+0.083,Y =0.048 BPD+0.063,Y = 0.054 FL + 0.124,respectively.Conclusions In normal fetuses,the DLDs and DLDd increase with the growth of GA,and have good correlation with GA,BPD,and FL respectively.Normal reference ranges of DLDs and DLDd have been provided.These normative data may be a new tool for assessment of fetal heart,especially has potential applications in screening of total anomalous pulmonary venous connection(TPVAC),absent pulmonary valve syndrome(APVS)or other complex congenital heart defects.

This study was aimed to observe the effect of Bai-Zhu Fu-Ling (BZFL) Decoction in different proportion-ing on VIP and VIPR1 in Crohn's disease (CD) rats with spleen deficiency syndrome, in order to further explore the immunologic mechanism of BZFL Decoction on CD. The CD rat model with spleen deficiency syndrome was estab-lished using exhaustion and hunger. The model rats were treated by BZFL Decoction with different proportioning, and immunohistochemistry (IHC) was used to detect the expression of VIP and its receptor in colon tissues. The results showed that comparing to the blank control group, the level of VIP and its receptor of the model group significantly increased (P< 0.05). Comparing to the model group, the level of VIP and its receptor in BZFL Decoction B5 group (Rhizoma A tractylodis Macrocephalae:Poria = 12:15), B6 group (Rhizoma A tractylodis Macrocephalae:Poria = 15:12) and B7 group (Rhizoma A tractylodis Macrocephalae:Poria = 18:9) was significantly decreased (P< 0.05). It was con-cluded that the effect of BZFL Decoction of B5 group, B6 group and B7 group was better than other groups in VIP and its receptor which can regulate the VIP and its receptor, inhibit the releasing of inflammatory factors and reduce intestinal inflammation injury.

Objective To explore the significance of MYCN gene amplification in children with neuroblastic tumors(NT).Methods The clinicopathological data of 154 cases with NT were reviewed,including general data, classification of pathology,clinical stage and prognosis.MYCN gene amplification was detected by fluorescence in situ hybridization(FISH) and its relationship between pathological characteristics and prognostic significance was analyzed.Results There was 154 cases of NT aged 1 day to 11 years,with a mean age of 26.1 months,and the median age of 20.5 months.Male and female ratio was 1.48 : 1.00.According to International Neuroblastoma Staging System (INSS) ,20 cases were of stage Ⅰ (13.0％) ,23 cases of stage Ⅱ (14.9％) ,43 cases of stage Ⅲ (27.9％) ,64 cases of stage Ⅳ(41.6％) and 4 cases of Ⅳs (2.6％).There were 72 cases(46.8％) with favorable histology,and 82 cases(53.2％) with unfavorable histology.MYCN amplification was found in 20 cases (13.0％) and the signal ratio of MYCN and chromosome 2 (CEP2) was 4.08-43.29.One hundred and thirty-four cases of MYCN non-amplification included MYCN gain in 91 cases(68.0％) ,MYCN negative in 43 cases(32.0％).MYCN expression showed the significant differences in ages, neuroblastoma type, international neuroblastoma pathology classification (INPC), mitosis karyorrhexis index (MKI), and clinical stages (all P ＜ 0.05).No significant difference was found in gender(P ＞ 0.05).Of 20 MYCN amplification cases,4 cases (20.0％) survived and 16 cases (80.0％) died,and the overall survival rate was 20.0％ (4/20 cases) ,with survival time was (17.10 ± 2.24) months;of 134 MYCN non-amplification cases,96 cases (71.6％) survived and 38 cases (28.4％) died, with survival time of (28.71 ± 1.28)months.Survival analysis showed the cases with MYCN amplification had worse prognosis (x2 =19.596, P ＜ 0.05).Conclusions Patients with MYCN amplification had poorer prognosis and lower incidence of MYCN amplification of pediatric NT was found in China.

Purpose To investigate the histopathological features of cystic lung diseases ( CLD) , and to discuss the timing of clinical interventions. Methods HE and immunohistochemical staining were performed and reviewed in 125 cases of CLD. Results 125 ca-ses of CLD aged from birth to 11 years and 6 month, with an average age of 23. 0 months, median age 15 months, of which 60 cases were less than 1 year (48. 0%). 75 cases were male and 50 cases female, with male to female ratio of 1. 5 ∶ 1. Grossly, 50 cases showed single or multiple cysts with the size 0. 5 ~8. 0 cm in diameter, which did not communicate with bronchial cavity. 18 cases showed honeycomb cysts with the diameter of 0. 1~2. 0 cm. 26 cases were solid lesions without visible cysts. 21 cases were observed lung abscess with thick and rough wall and pus inside. 7 cases of emphysema showed microcysts with crepitation. 2 cases were identi-fied cystic and solid masses, with fish-fresh like cut surface. Histopathologically, 94 cases (75. 2%) were related to congenital bron-chopulmonary dysplasia in 125 cases of CLD, in which there were 59 patients (47. 2%) of congenial pulmonary airway malformation (CPAM), including 29 cases of type 1 (49. 2%), 18 cases of type 2 (30. 5%), and 12 cases of type 4 (20. 3%), there were 26 ca-ses (20. 8%) of pulmonary sequestration, including 15 cases of intralobar type (57. 7%) and 11 of extralobar cases (42. 3%), 5 ca-ses were complicated with CPAM type 2, 8 cases were bronchial cyst (6. 4%) and 1 case of enteric cyst (0. 8%). Acquired lesions were detected in 31 cases (24. 8%), including 21 cases of infected lung abscess, 1 case of fungal abscess. 7 cases of emphysema, and 3 cases of pleuralpulmonary blastoma (typeⅠ1 case and typeⅡ2 cases). Conclusion Pediatric CLD is characterized as com-plexed categories. The prognosis depends on correct pathological diagnosis, combined with imaging evaluation and appropriate timing of surgery.

Objective To confirm the correlation between pre or post processing semen parameters and clinical pregnancy rate in infertile couples with male factors undergoing intrauterine insemination (IUI) .Methods The pregnancy rate based on ovulation in‐ducing agent in infertile couples with male factors infertility per the 2010 world health organization criteria treated with IUI was e‐valuated .One hundred and twenty eight cycles were divided into pregnant group (16 cycles) and non‐pregnant group(112 cycles) . The pre or post processing semen parameters were retrospectively evaluated .Results The overall pregnancy rate was 12 .5% .All parameters in this study has no statistically significant difference between the two groups (P>0 .05) .Logistic multivariate analysis showed that there was no significant correlation between semen parameters and clinical pregnancy rate (P> 0 .05) .Conclusion There are no significant correlations between semen parameters and clinical pregnancy rate when the normal forms of patients with male infertility was 4% or higher .No semen parameters could predict results of clinical pregnancy .

Objective To evaluate the correlation between homologous recombination repair protein RAD51 and methotrexate-enhanced radiosensitivity.Methods Western blot and RT-PCR assays were used to detect RAD51 expression in HOS osteosarcoma cells exposed to γ-ray irradiation alone and in combination with methotrexate.Colony formation assay was used to test the survival fraction of HOS cells exposed to γ-rays and methotrexate.Results Methotrexate inhibited both protein and RNA expressions of RAD51,and the combination of radiation and methotrexate enhanced the inhibition of RAD51 expression.Moreover,transfection of cells with RAD51 gene decreased cellular sensitivity to methotrexate and γ-rays.The sensitizer enhancerment ratios after irradiation in combination with methotrexate were 1.51 and 0.99,respectively.Methotrenate was a preferred radiosensitizer to HOS cell.Conclusions RAD51 might be involved in the methotrexate-enhanced radiosensitivity.