Ojbective　To elucidate the poathogenic bacteria\,hazards and critical days of uninary tract hospital infection after renal transplantation.Methods　To monitor regularly the pathogenic bacteria of urine in 164 cases during their hospitalizations after renal transplantation.The relations beween multifactors and the pathogenic bacteria and the uninary tract infection rate were analysed statistically.Conclusions　3～13 days after renal transplantation were critical days.The fungi and enterobacteriaceae were chief pathogenic bateria.Acute rejection of the ransplant kidney and the immunlogical management,indwelling catheter,broad-spectum antibiotics wer main factors to influence the pathogenic bacteria and the infection rate.Tranining the quality of nurses\,stricting standard operation\,reducing iatrogenic operation\,completing instruction\,available usage of medicine shoud be valued in nursing after renal transplantation.

Objective To investigate the correlation between human leukocyte antigens-A,-B,-DRB1 (HLA-A,-B,-DRB1) high resolution alleles and chronic renal failure (CRF) caused by immunoglobulin-a nephropathy (IgAN).Method The polymerase chain reaction-sequence-based typing (PCR-SBT) method was used to investigate the genotypes of HLA-A,-B and-DRB1 high-resolution alleles in 191 cases of CRF caused by IgAN (experimental group) and 503 healthy blood donors (control group).The alleles frequencies between two groups were compared and the association between CRF caused by IgAN and the polyrnorphism of HLA was analyzed.Result (1) There were 25 alleles at A locus,48 alleles at B locus and 32 alleles at DRB1 locus in experimental group.(2) The genetic frequency of HLAA * 2901 [Pc =0.033,OR =10.738,95％ CI (1.193,96.691)],HLA DRB1 * 1106 [Pc =0.0001,OR =0.969,95％ CI (0.944,0.994)],HLA-DRB1 * 1202[Pc =0.002,OR =1.859,95％ CI (1.259,2.745)],HLA-DRB1 * 1401 [Pc =0.021,OR =0.984,95％ CI (0.967,0.998)],HLA-DRB1 * 1602[Pc=0.015,OR=1.915,95％ CI (1.157,3.17)] in experimental group was higher than in control group (P＜0.05).Conclusion There is susceptibility association of HLA-A * 2901,HLA-DRB1 * 1106,HLA-DRE * 1202,HLA-DRB1 * 1401,HLA-DRB1 * 1602 with CRF caused by IgAN.It is concluded that there is a close genetic and immunological correlation between HLA alleles and the pathogenesis of CRF caused by IgAN.

Objective To explore how to reasonably deploy the wounded and sick region on the medical evacuation ship.Methods Three models of the wounded and sick region were set up according to different demand.Simulated exercises were imitated and medical staff and experts selected reasonable models.Results Most medical staff and experts selected the model which deployed the wounded and sick region according to whether the condition of an injury should be treated.Conclusion It is scientific and reasonable that the wounded and sick region is deployed according to whether the condition of an injury should be treated.

ObjectiveTo investigate the factors for standard TAC-related nephrotoxicity in renal transplant recipients. MethodsClinical data of 132 patients in TAC-based regiment with a dose of 0. 15-0.3 mg· kg-1 · day-1 and a trough level of 8-11 μg/L during first 2 years post renal transplantation, were retrospectively analyzed. TAC-related nephrotoxicity was diagnosed by renal biopsy and/or clinical criteria. All recipients were divided into 2 groups: TAC nephrotoxicity group (n = 25) and control group (n = 107). Logistic regression analysis was used to rank the relative risk of potential variables including age, gender, delayed graft function (DGF), drug exposure, duration of therapy,liver function, albumin level, hematocrit and gene polymorphism for CYP3A5 and MDR1.ResultsTAC-related nephrotoxicity was found in 25 (18. 9 ％ ) recipients. Univariate and Logistic regression analysis revealed that the influencing factors for TAC-related nephrotoxicity with a standard immunosuppressive regimen and a normal trough level range were identified as: abnormal liver function (RR = 3. 05,95 ％ CI 0. 879-11. 533, P = 0. 024), albumin level (RR = 0. 966,95 ％ CI 0. 994-1. 006, P = 0. 018 ), hematocrit ( RR = 0. 999, 95 ％ CI 0. 998-1. 000, P = 0. 032), CYP3A5 gene polymorphism (RR= 0. 777,95 ％ CI 0. 023-6. 798,P= 0. 032) ,and MDR1 gene polymorphism (RR=0. 654,95 ％ CI 0. 053-7. 109, P = 0. 017). ConclusionLiver function, albumin level, hematocrit, and gene polymorphism for CYP3A5and MDR1as well are influencing factors for TAC-related nephrotoxicity in renal transplant recipients with a standard immunosuppressive regimen and a normal trough level range,in which abnormal liver function is the most important adverse risk factor. These factors should be considered for better individual therapy in renal transplant recipients.

ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.

ObjectiveTo know about the correlation analysis of the physical and mental status of organ transplanted patients' family members during the patients' rehabilitation period and the long term survival of the transplanted organs.MethodsA total of 600 organ transplanted patients' family members were investigated by Zung self-rating anxiety scale (SAS) and simple coping style questionnaire.The results underwent subsequent analysis.ResultsAnxious state of organ transplanted patients' family members was more severe than that of domestic norm (P<0.01).There were some differences in terms of anxious state of family members with different genders,education backgrounds,income and the resource of medical expenditure (P<0.05).Family members most took positive coping styles,whereas fewer adopted negative coping styles (P<0.01).Positive coping styles were negatively correlated with the anxiety of family members (P<0.01) and positively correlated with long term survival of transplanted organ(P<0.05).However,negative coping styles of family members were significantly positively correlated with their anxiety (P<0.05) and were negatively correlated with long term survival of transplanted organ.ConclusionsThe anxiety generally exists in organ transplanted patients' family members.There are differences in terms of anxious state among family members of different genders,different education backgrounds,income or with the resource of medical expenditure.The more they adopt positive coping styles,the lower anxiety level they show and the longer the transplanted organ survive.Conversely,the more they adopt negative coping styles,the higher anxious level they show and the shorter the transplanted organ survive.

Objective To explore the outcomes of kidney transplant recipients who developed urinary and male genital cancers after transplantation. Methods Data of 31 kidney transplant recipients developed de novo urinary and male genital cancer were compared with data of 31 patients in general population with the same age and same tumor stage. Results Compared with the general population, the overall survival was significantly worse in the transplant recipients (P=0. 02) , 5-year survival rates for each group were 50% vs 68%. Multivariate analyses demonstrated cancer stage to be a negative risk factor for survival for transplant recipients with de novo urinary and male genital cancer, and surgery and functioning graft to be the positive survival predictors. Conclusions Transplant recipients experience worse outcomes than the general population from urinary and male genital cancers. Cancers in transplant recipients are more biologically aggressive at the time of diagnosis.

BACKGROUND: Insulin resistance may be a risk factor for hypertension,but the relationship between insulin resistance and hypertension are quite different from different race or nationalities. OBJECTIVE: To analyze the relationship between insulin resistance and hypertension in Chinese Mongolian population.DESIGN: Prevalent investigation.SETTING: Staff Room of Epidemiology, Public Health College of Harbin Medical University. PARTICIPANTS: Totally 232 patients with primary hypertension and persons with normal blood pressure, aged from 30-60 years from Kezuohouqi of Tongliao city in June 2001 based on the prevalent survey, and they all Mongoloid population. Examination was performed and blood pressure was measured. They were involved in this investigation after signing the consent. Other cardiovascular disease patients were excluded.METHODS: A total of 115 patients with primary hypertension and 117normotensives were selected with cluster sampling method. Height, body mass, waistline, hip line and waist-to hip ratio (WHR), I.e. Waist line/ hip line were standardization method. Body mass index (BMI) ＜ 24 kg/m2 or waist-to-hip ratio (WHR) ＜ 0.9, body mass or somatotype was partial to normal. Blood glucose was detected with glucose meter. Radio-immunoassay (RIA) were utilized to measure insulin and C-peptide. Degree of insulin resistance was determined by means of insulin sensitivity index (ISI), ISI =-ln [glucose (mmol/L) × insulin (Mu/L)]. After considering the effect of BMI and WHR as well as the stratification of BMI (≥24 kg/m2 and ＜ 24 kg/m2) and WHR (≥ 0.9 and ＜ 0.9), statistical analysis was performed. MAIN OUTCOME MEASURES: ISI of the investigational subjects of the two groups. RESULTS: Totally 232 included investigational subjects were involved in the result analysis, without drop out. ①Comparison of ISI of the investigational subjects of the two groups: The ISI of the hypertension group was slightly lower than that of the normotensive group, but the difference was not significant [-3.56±0.27,-3.50±0.20(P ＞ 0.05)]. ②Comparison of ISI of the investigational subjects of the two groups after delamination according to BMI and WHR: When the BMI was less than 24, the ISI in the hypertension group was lower distinctly than that in the normotensive group [-3.56+0.27,-3.48±0.17(F=5.037, P ＜ 0.05)]. When the WHR was less than 0.9, the ISI of the hypertension group was lower dramatically than that in the normotensive group [-3.57+0.27,-3.49+0.20(F=4.537, P ＜ 0.05 )].CONCLUSION: The insulin resistance may be related to primary hypertension in non-obese Chinese Mongolian population.

Objective To explore the outcome for kidney transplant recipients who suffered from cancers after transplantation. Methods De novo cancer data in 59 transplant recipients were collected. 6 cases of native renal cell carcinomas, 4 cases of native pelvo-ureteral carcinomas, 14 cases of bladder cancers, 7 cases of prostate cancers, 9 cases of hepatocellular carcinomas, 3 cases of gastric carcinomas, 2 cases of colon cancers, 1 case of pancreatic cancer, 4 cases of breast cancers, 3 cases of cervical cancers, 2 cases of skin cancers, 2 cases of non-small cell lung cancers, 1 case of thyroid cancer and 1 case of post-transplant lymphoproliferative disease. These data were compared with those from 59 patients in general population with the same gender, age and tumor stage. Results Overall incidence rate for de novo malignancy post-transplantation was 1. 9 % (59/3150). Urinary cancers were the most common. Compared to the general population, the overall survival was significantly worsened in transplant recipients (P<0. 01), and 5-year survival rate in transplantation group and control group was 30 % vs 75 0 %. Multivariate analyses demonstrated cancer stage to he a negative risk factor for survival of transplant recipients with de novo cancer, and surgery and functioning graft to be the positive survival predictors. Conclusion Transplant recipients experience worse outcomes than the general population for these cancers. These data suggest that cancers in transplant recipients are more aggressive biologically at the time of diagnosis.

Objective To investigate the therapeutic methods of hyperpotassemia induced by excessively high blood concentration of tacrolimus (FK506) caused by drug use after renal transplantation. Methods Clinical data of 10 patients diagnosed with hyperpotassemia induced by excessively high blood concentration of FK506 after administration of antifunga l medication following renal transplantation were collected and retrospectively analyzed. Results At 1-2 months after renal transplantation, 10 patients suffered from pulmonary infectiono r pneumonia complicated with pulmonary fungal infection . An appropriate dose of compound sulfamethoxazole, micafungin, cefoperazone sodium-sulbactam sodium and moxifloxacin was administered for antifungal infection. After potassium-lowering therapy, termination of antifungal medication and FK506 dose adjustment (replaced by cyclosporin for certain cases), the serum level of potassium was declined and maintained within normal range for 10 cases. The serum concentration of FK506 was within normal range. No sign of excessively high level of potassium was observed without any potassium-lowering intervention. Conclusions Postoperative administration of drugs is likely to cause excessively high level of FK506 and hyperpotasesmia. Potassium-lowering therapy, termination of drug use and adjustment of immunosuppressive agents should be adopted to avoid the incidence of adverse pharmacologic interaction.