Objective:To explore the clinical efficacy of single-center infant kidney donor adult dual kidney transplantation to explore the difference of different operation methods and the operation options of different donor kidney conditions so as to improve the success rate of children kidney donor adult dual kidney transplantation and reduce complications.Methods:A total of 42 cases of infant and adult dual kidney transplantations at Department of Kidney Transplantation in The Second Xiangya Hospital of Central South University from December 2012 to May 2019 were divided into two groups according to whether or not donor kidney fulfilled the criteria of three " 5" . According to different surgical approaches, they were divided into three groups of A (classical En-Bloc operation), B (separated dual kidney transplantation) and C (modified operation). The clinical data and prognoses were analyzed.Results:The median follow-up period was 55(11-92) months. The estimated glomerular filtration rate was 123.4(92.2-156.6) ml/min for operation A, 97.2(81.3-116.6) ml/min for operation B and 133.9(133.9-133.9) ml/min for operation C. In donor group not fulfilling the " 5" principle, no thrombotic event occurred for operation A/C and 3 cases of transplantation for operation B. There were single renal embolism ( n=2) and dual renal embolism ( n=1)(3/5, 60%)( P<0.05). Urinary protein was positive in the last follow-up: operation A (1/2, 50%) and operation B (3/5, 60%) ( P<0.05). The estimated glomerular filtration rate at the last follow-up was 82.4(80.9-83.9) ml/min for operation A, 71.8(46.1-114.2) ml/min for operation B and 122(83.3-142.4) ml/min for operation C. The 1-year graft survival rate was 100% and 89.5% in three " 5" donor group and 3-year graft survival rate was 100% and 84.2% respectively. Conclusions:Satisfactory outcomes might be obtained during dual kidney transplantation for infants and adults. The incidence of thrombosis, urine leakage and urinary protein is lower in improved kidney transplantation group than that in previously operated group. The problem of graft hyperperfusion injury is well solved. And the long-term follow-up outcome is excellent.

Objective To investigate the influence of nerve growth factor (NGF) on the ability of differentiation and proliferation of regulatory T cells (Tregs) induced by mesenchymal stem cells (MSCs).Methods The MSCs were stimulated directly by NGF.IL-10,TGF-β and HLA-G were tested.The expression of CD4 and CD25 was detected by flow cytometry after co-culture.The expression of CD4,CD25 and Foxp3 was detected by flow cytometry after Transwell co-culture.Results As compared with control group,the expression of IL-10,TGF-β and HLA-G in NGF group was increased (P＜0.05 for all).The number of Tregs was increased after the co-culture (P＜0.05).The reduction in IL-10 and TGF-β could block the inducing function of NGF (P＜0.05).Conclusion NGF can enhance the ability of differentiation and proliferation of Tregs induced by MSC,which is possibly associated with the increases in the expression of IL-10 and TGF-β.

Objective To evaluate the curative effects of vacuum sealing drainage equipment on prevention and treatment of subcutaneous effusion after breast cancer radical correction. Methods A total of 122 cases of breast cancer patients from June 2006 to June 2012 were randomly divided into control group ( n=62) and intervention group (n=60). The patients of control group underwent the conventional drainage while the patients of intervention group received the vacuum sealing drainage. The situation of subcutaneous effusion, infection, skin flap necrosis, decannulation time as well as day flow conditions in two groups were observed and compared. Results The incidence of subcutaneous effusion, infection and skin flap necrosis in control group were 12. 9%, 6. 4%, 8. 1% respectively. In intervention group, the incidence rate of subcutaneous effusion was 1. 7%, and no infection, and skin flap necrosis had been observed (χ2 =7. 90,8. 31,9. 12;P<0. 01). The extubation time and day flow conditions in control group was(6. 8 ± 2. 3) d and (70 ± 38) ml, while the interventiongroupwere(10.5±3.1)dand(105±28)mlwithstatisticalsignificance(t =2.10,3.95;P <0. 05). Conclusions Simple vacuum sealing drainage device can not only prevent the subcutaneous effusion, infection and skin flap necrosis after breast cancer radical correction, but also can realize the early extubation, therefore it is worthy of promotion in clinical.

OBJECTIVE: To gain an insight into the transplantation with donor kidneys from extended criterion donation after cardiac death (DCD) and to improve the management during and after renal transplantation METHODS: Renal transplantation in 2 patients who used organs from small pediatric donors (<3 years) was performed. The graft kidneys were procured from 1 donor aged 11 months and the other 1 year and 7 months. The 2 donors were diagnosed as brain death caused by serious infantile hepatitis syndrome and severe craniocerebral injury, respectively. After the cardiac death, en bloc organ resection was performed. En bloc kidneys were transplanted to 2 adult recipients who were 37 and 41 years old, respectively. RESULTS: The recipients were followed-up for 6 months. Both of them developed large volume of bloody drainage in the early post-operational period and relieved after relevant treatment. The kidney grafts functioned well and no other surgical complications or acute rejections happened during the follow-up. CONCLUSION Based on modified peri-operative techniques, it is safe to perform renal transplantation with kidneys procured from cardiac death donors who are younger than 3 years old, an important source to increase the number of organs available for transplantation, yet the vascular complications require attention.
Adult ; Graft Survival ; Humans ; Infant ; Kidney ; Kidney Transplantation ; Postoperative Period ; Tissue Donors

Objective:To explore the clinical efficacy of adult donor dual kidney transplantation.Methods:Retrospective analysis of case data of 13 adult donor kidney dual kidney transplantation (DKT) performed in the The Second Xiangya Hospital of Central South University from September 2016 to December 2020. For 13 donors, the average age and BMI were (53.5±12.4)years and (24.3±2.8) kg/m 2, respectively. Their mean Serum creatinine (SCr) at admission and before procurement was (132.9±54.1)and (228.7±112.4)μmol/L, respectively. 3 of them had diabetes mellitus history, and 8 had hypertension history. 11 met the United Network for Organ Sharing (UNOS) DKT criteria and 6 met Remuzzi score DKT criteria. For 13 recipients, the average age and BMI were (39.3±8.9)years and (20.2±2.4)kg/m 2, respectively. All of them received ABO blood type-matched kidney transplants. 2 of them had their grafts transplanted in the bilateral iliac. In 12 cases, the grafts filled rapidly and urinated immediately when opening blood flow. In 1 case, the grafts were dark in color and vascular showed weak pulsation after opening blood flow. The time to recovery of perioperative graft function (from the day of surgery to the natural reduction of SCr to the normal range 44-133μmol/L), the occurrence of delayed graft function (DGF), acute rejection (AR), ureteral and surgical incision complications, as well as the recipients’ final follow-up SCr, eGFR, urinary protein, and grafts outcome were observed. Risk factors affecting outcomes were assessed by univariate logistic regression analysis. Results:The SCr dropped to the normal range at discharge in 10 recipients, and the average recovery time was (13.8±13.0) days. In other 3 cases SCr at discharge were 300.0, 149.0, 152.5μmol/L. 4 cases had DGF, 4 had AR, 1 experienced urinary fistula, and 1 experienced incisional dehiscence, which were treated with anti-rejection, J-tube implantation, continuous catheterization to maintain bladder void, secondary suturing, respectively. The follow-up time ranged from 4 to 54 months, with a median of 28(15.5, 31.0) months. At the final follow-up time, 10 cases had good graft function, 2 suffered impaired kidney function, and 1 experienced graft failure. The average SCr and eGFR except for graft failure patient were (144.2±101.3)μmol/L and (52.9±21.2)ml/min, respectively. 4 had positive urine protein. Univariate logistic regression analysis showed that donor age, BMI, history of diabetes mellitus and hypertension, and SCr were not significantly correlated with recipients’ DGF and graft impairment ( P>0.05), and due to the small sample size, multifactorial logistic regression analysis was not performed. Conclusion:The short to medium-term effects of adult donor DKT coule be safe and feasible.

Objective: Immunoglobulin A nephropathy (IgAN) is one of the most common types of kidney disease, and kidney transplantation is the most effective treatment for end-stage renal disease. This study aims to analyze the clinical curative effect of renal transplantation for adults with IgAN and to discuss the efficacy and safety of kidney transplantation for IgAN at the perioperative period and medium- and long-term follow-up. Methods: This retrospective study included the clinical and follow-up data of 81 adult patients with IgAN who underwent kidney transplantation at the Second Xiangya Hospital, Central South University from January 2018 to January 2022. Of the 81 patients whose age at (34.1±9.9) years old, 47 (58.0％) were male. The body mass index was (20.8±3.2) kg/m2, and the human leukocyte antigen (HLA) mismatch number was 3.5±1.2. The estimated glomerular filtration rate (eGFR) and daily 24-hour urine output for the recipients on the 1st, 5th, and 7th day after kidney transplantation and when they were discharged were analyzed. The recovery of the transplanted kidney and occurrence of complications were comprehensively evaluated. The eGFR, urinary protein, and occult blood were evaluated at the 6th, 12th, 24th, 36th, and 48th month and at the last follow-up. Results: The follow-up time was (25.7±15.8) months. No primary non-function occurred in any patient during the perioperative period time. Fifty-one (63.0％) patients had immediate graft function recovery, and 16 (19.8％) patients had slow graft function recovery. Delayed recovery of graft function was observed in 14 (17.3％) patients. A total of 19 perioperative complications occurred, including 9 patients with acute rejection, 5 patients with urinary fistula, 1 thrombosis in both lower limbs, and 4 lymphatic fistula. The eGFR at 6th, 12th, 24th, 36th, and 48th month of follow-up were (65.3±22.9), (67.6±23.0), (64.3±21.8), (65.9± 24.7), and (68.7±31.2) mL/(min·1.73 m2), respectively. The eGFR remained high during the medium- and long-term follow-ups. At the longest follow-up of 56 months, eGFR fluctuation was still mild, and the positive rate of urine protein and occult blood was low. IgAN recurred in 4 transplanted kidneys, accounting for 4.94％ of the total patients, without severe renal insufficiency. Three patients had kidney dysfunction due to severe pneumonia, rejection, and stone in the transplanted kidney. The overall survival rate of the transplanted kidney was higher than 95％, and the survival rate of all patients was 100％ till Januray 2022. Conclusion: Renal transplantation for adults with IgAN had a remarkable short-term effect. The recipients can be beneficial significantly to favorable midium- and long-term outcomes. IgAN recurrence is infrequent and rarely causes severe renal function damage.

Photoplethysmography (PPG) is a non-invasive technique to measure heart rate at a lower cost, and it has been recently widely used in smart wearable devices. However, as PPG is easily affected by noises under high-intensity movement, the measured heart rate in sports has low precision. To tackle the problem, this paper proposed a heart rate extraction algorithm based on self-adaptive heart rate separation model. The algorithm firstly preprocessed acceleration and PPG signals, from which cadence and heart rate history were extracted respectively. A self-adaptive model was made based on the connection between the extracted information and current heart rate, and to output possible domain of the heart rate accordingly. The algorithm proposed in this article removed the interference from strong noises by narrowing the domain of real heart rate. From experimental results on the PPG dataset used in 2015 IEEE Signal Processing Cup, the average absolute error on 12 training sets was 1.12 beat per minute (bpm) (Pearson correlation coefficient: 0.996; consistency error: -0.184 bpm). The average absolute error on 10 testing sets was 3.19 bpm (Pearson correlation coefficient: 0.990; consistency error: 1.327 bpm). From experimental results, the algorithm proposed in this paper can effectively extract heart rate information under noises and has the potential to be put in usage in smart wearable devices.
Algorithms ; Heart Rate/physiology* ; Photoplethysmography/methods* ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

The effect of living kidney transplantation between identical twins is satisfied, but it is rarely reported. From October 2019 to February 2021, two recipients received kidney transplantation from their twin sisters in the Second Xiangya Hospital of Central South University. The primary disease of the two recipients was acute glomerulonephritis in 1 case and diabetic nephropathy in 1 case. Two recipients received tacrolimus/cyclosporine+ mortemycophenol ester+ methylprednisolone after surgery. The patients were followed up for 3.0 and 1.5 years, respectively, with renal function recovering well.